Surprise Medical LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

SURPRISE MEDICAL LLC

Practice address

16960 W Bell Rd Ste 501
Surprise, AZ 85374-8946

Phone

(480) 634-6400

Fax

(480) 404-9649

NPI assigned

Jan 31, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Challen Waychoff III

Title

Coo/Manager

Phone

(480) 634-6400

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520812800000",
    "number": "1023516499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 N 3RD ST STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122035",
            "telephone_number": "480-634-6400",
            "fax_number": "480-404-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16960 W BELL RD STE 501",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853748946",
            "telephone_number": "480-634-6400",
            "fax_number": "480-404-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURPRISE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-03-12",
        "status": "A",
        "authorized_official_last_name": "WAYCHOFF",
        "authorized_official_first_name": "CHALLEN",
        "authorized_official_title_or_position": "COO/MANAGER",
        "authorized_official_telephone_number": "480-634-6400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surprise Implants & Prosthodontics PLLC
• Surprise Luxury Assisted Living LLC
• Surprise MC, LLC
• Surprise Medical Consultants LLC
• Surprise Medical Group LLC
• Surprise Memory Care, LP
• Surprise Modern Dentistry LLP
• Surprise Optometric Care
• Surprise Pain and Spine
• Surprise Pediatric Dentistry, PC

• Physical Medicine & Rehabilitation Physician in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.