Organization Active NPI

Phantom Surgical LLC

  • Surgical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1063386332
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
PHANTOM SURGICAL LLC
Practice address
19820 N 7TH St Ste 208
Phoenix, AZ 85024-1694
Phone
(480) 773-1803
NPI assigned
Sep 30, 2025
Last updated
Sep 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Authorized official

Name
Brett McLaughlin
Title
Director
Phone
(480) 773-1803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

19820 N 7TH St Ste 208
Phoenix, AZ 85024-1694

Mailing address

PO Box 41340
Phoenix, AZ 85080-1340
Phone (480) 773-1803

National Provider Directory

National Provider Directory

Locations

19820 N 7th St
Ste 208
Phoenix, AZ 85024
Phone (480) 773-1803

NPI Registry JSON

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

{
    "created_epoch": "1759190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1063386332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41340",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850801340",
            "telephone_number": "480-773-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19820 N 7TH ST STE 208",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850241694",
            "telephone_number": "480-773-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHANTOM SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-30",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "MCLAUGHLIN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-773-1803"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "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 Sep 30, 2025; 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.