Sonoran Spine Center P.C.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

SONORAN SPINE CENTER P.C.

Practice address

1255 W Rio Salado Pkwy Ste 105
Tempe, AZ 85281-2892

Phone

(602) 443-6480

Fax

(602) 443-6499

NPI assigned

May 3, 2006

Last updated

Jun 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Dylo

Title

Administrator

Phone

(480) 962-0071

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ICIFBD

Practitioners 32

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.

• Albert Bednar, DPT

  • Physical Therapist
  • Mesa, AZ
  • NPI 1538258496
  Medicare reassignment NPD
• Dennis G Crandall, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Mesa, AZ
  • NPI 1255399549
  Medicare reassignment NPD
• Jason C Datta, MD

  • Orthopaedic Surgery of the Spine Physician
  • Tempe, AZ
  • NPI 1700854296
  Medicare reassignment NPD
• Amy Jones, DPT

  • Physical Therapy Clinic/Center
  • Mesa, AZ
  • NPI 1083033997
  Medicare reassignment NPD
• Keikhosrow Mosallaie, DO

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1306808993
  Medicare reassignment NPD
• Kelli M Patterson, NP

  • Family Nurse Practitioner
  • Tempe, AZ
  • NPI 1891211538
  Medicare reassignment NPD
• Geneva Gertrude Smith, A.C.N.P.

  • Acute Care Nurse Practitioner
  • Glendale, AZ
  • NPI 1952340762
  Medicare reassignment NPD
• Yolanda Ann Smith, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1417227695
  Medicare reassignment NPD
• Robert Waldrop III, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Tempe, AZ
  • NPI 1952531022
  Medicare reassignment NPD
• Lyle Young, MD

  • Orthopaedic Surgery of the Spine Physician
  • Tempe, AZ
  • NPI 1194979427
  Medicare reassignment NPD
• Andrew Chung, DO

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
  • NPI 1750709036

  AZ, Orthopaedic Surgery of the Spine

  Medicare reassignment NPD
• Matthew Keith Wingate, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Tea, SD
  • NPI 1871898239

  AZ

  Medicare reassignment NPD

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1013975333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W RIO SALADO PKWY STE 107",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852812892",
            "telephone_number": "480-962-0071",
            "fax_number": "480-962-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W RIO SALADO PKWY STE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852812892",
            "telephone_number": "602-443-6480",
            "fax_number": "602-443-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONORAN SPINE CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "DYLO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-962-0071"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Son
• Song Kai Massage PLLC
• Sonora Quest Laboratories LLC
• Sonoran Care Services LLC
• Sonoran Physical Therapy
• Sonoran Surgical PLLC
• Sonoran University of Health Sciences
• Kameron Soper
• Scott H. Sorensen, P.A.-C
• Kimberly Soricone

• Orthopaedic Surgery of the Spine Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Orthopaedic Surgery of the Spine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.