South Mountain Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTH MOUNTAIN SURGERY CENTER, LLC

Practice address

15810 S 45TH St Ste 150
Phoenix, AZ 85048-7655

Phone

(480) 747-6240

Fax

(480) 747-6238

NPI assigned

Oct 15, 2018

Last updated

Jan 22, 2019By 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

Mike Burrola

Title

General Manager

Phone

(623) 302-0850

Specialties & licenses 1

Addresses

Practitioners 1

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.

• John J. Baca, DC

  • Chiropractor
  • Chandler, AZ
  • NPI 1013975200
  NPD (past)

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1073089215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15810 S 45TH ST STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487655",
            "telephone_number": "480-747-6240",
            "fax_number": "480-747-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15810 S 45TH ST STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487655",
            "telephone_number": "480-747-6240",
            "fax_number": "480-747-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH MOUNTAIN SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-15",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "BURROLA",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "623-302-0850"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Mountain Dental Care Center
• South Mountain Dental Partners LLC (Risas Dental and Braces)
• South Mountain Family Psychiatry, LLC
• South Mountain Physical Therapy LLC
• South Mountain Rehabilitation P.C.
• South Phoenix Integrity House LLC
• South Phoenix Prep and Arts Academy
• South Phoenix Veterans Group Home
• South Town Dental Care, Inc. (Garden Lakes Family Dentistry)
• South Valley Prep and Arts School

• Ambulatory Surgical Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.