Southwest Sports Medicine & Orthopaedic Surgery Clinic

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

3696 Issued in AZ

Legal business name

SOUTHWEST SPORTS MEDICINE & ORTHOPAEDIC SURGERY CLINIC

Practice address

4566 E. Inverness Rd.
Ste. 101
Mesa, AZ 85206

Phone

(480) 763-5950

Fax

(480) 763-1375

NPI assigned

Oct 29, 2009

Organization subpart

Yes

Parent organization

SOUTHWEST SPORTS MEDICINE & ORTHOPAEDIC SURGERY CLINICAs reported in NPPES

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

Authorized official

Name

Mr. Angelo J. Mattalino

Title

Owner

Phone

(480) 860-2618

Specialties & licenses 1

Addresses

Part of

Southwest Sports Medici

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Southwest Sports Medicine & Orthopaedic Surgery Clinic, LTD.

  • Orthopaedic Surgery Physician
  • Scottsdale, AZ
  • NPI 1295827384
  NPPES parent name

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256774400000",
    "number": "1083940837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8129 N. 87TH PLACE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85258",
            "telephone_number": "480-860-2618",
            "fax_number": "480-998-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4566 E. INVERNESS RD.",
            "address_2": "STE. 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-763-5950",
            "fax_number": "480-763-1375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SPORTS MEDICINE & ORTHOPAEDIC SURGERY CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST SPORTS MEDICINE & ORTHOPAEDIC SURGERY CLINIC",
        "enumeration_date": "2009-10-29",
        "last_updated": "2009-10-29",
        "status": "A",
        "authorized_official_last_name": "MATTALINO",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-860-2618",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "AZ",
            "license": "3696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Southwest Network
• Southwest Oral Myofunctional Specialists
• Southwest Orofacial Group, Inc.
• Southwest Prime Consulting Services (Premier Health Network)
• Southwest Spine & Rehab PLLC
• Southwest Therapy Services
• Southwest Urgent Care, PLC. (McKellips Urgent Care)
• Southwestern Eye Center LTD
• Southwestern Eye Center LTD (Southwestern Eye Center-Falcon Field)
• Southwestern Eye Center LTD

• Orthopaedic Surgery Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Orthopaedic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; 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.