North Valley Endoscopy Center LLC

Key facts

NPI

1043239338

Entity type

Organization (NPI type 2)

Primary specialty

Ambulatory Surgical Clinic/Center 261QA1903X

License

OSC3960 (AZ)

Legal business name

NORTH VALLEY ENDOSCOPY CENTER LLC

Practice address

15255 N 40TH Street
Building 8
Phoenix, AZ 85032

Phone

(602) 482-1001

NPI assigned

Jul 18, 2006

Organization subpart

No

Authorized official

Name

Mr. Jeffrey Snodgrass

Title

President

Phone

(615) 665-1283

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Amsurg North Valley Anesthesia LLC Anesthesiology Physician · Phoenix, AZ · NPI 1629351788
  NPD member Member Of

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nickolas K Willard, CRNA Certified Registered Nurse Anesthetist · Scottsdale, AZ · NPI 1073816237
  Medicare reassignment NPD AZ
• Bernadette Pauline Miller, C.R.N.A. Certified Registered Nurse Anesthetist · Phoenix, AZ · NPI 1679678023
  NPD (past)
• Ryan Alec Chavez Certified Registered Nurse Anesthetist · Las Cruces, NM · NPI 1174061873
  NPD (past)

Medicare Care Compare: Ambulatory surgical center

Listed as

North Valley Endoscopy Center CCN 03C0001295

Medicare certification status

Active (Provider of Services file)

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare participation

Medicare fee-for-service enrollment

Enrolled in AZ

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 12, 2022.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1043239338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD # L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-240-3820",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15255 N 40TH STREET",
            "address_2": "BUILDING 8",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85032",
            "telephone_number": "602-482-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH VALLEY ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC3960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Phoenix, AZ · Ambulatory Surgical Clinic/Center in Arizona