Organization Active NPI

Az Institute of Spine and Sports Care, LTD

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
National Provider Identifier
1013219831
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
22892 Issued in AZ
Legal business name
AZ INSTITUTE OF SPINE AND SPORTS CARE, LTD
Practice address
20033 N 19TH Ave
Suite 108
Phoenix, AZ 85027-4245
Phone
(623) 516-8499
Fax
(623) 516-8641
NPI assigned
Nov 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robin Reece
Title
Office Manager
Phone
(623) 516-8499

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 22892 AZ Primary

Addresses

Primary practice location

20033 N 19TH Ave
Suite 108
Phoenix, AZ 85027-4245

Mailing address

20033 N 19TH Ave
Suite 108
Phoenix, AZ 85027-4245
Phone (623) 516-8499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110208000707 AZ Part B Supplier - Clinic/Group Practice 0446430425 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

20033 N 19th Ave
Ste 108
Phoenix, AZ 85027
Phone (480) 963-3034

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296604800000",
    "number": "1013219831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20033 N 19TH AVE",
            "address_2": "SUITE 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274245",
            "telephone_number": "623-516-8499",
            "fax_number": "623-516-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20033 N 19TH AVE",
            "address_2": "SUITE 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274245",
            "telephone_number": "623-516-8499",
            "fax_number": "623-516-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ INSTITUTE OF SPINE AND SPORTS CARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-30",
        "last_updated": "2011-02-02",
        "status": "A",
        "authorized_official_last_name": "REECE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "623-516-8499"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AZ",
            "license": "22892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.