Medshape Weight Loss Clinic, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

MEDSHAPE WEIGHT LOSS CLINIC, LLC

Practice address

7972 W Thunderbird Rd
106
Peoria, AZ 85381-4903

Phone

(623) 412-2700

Fax

(623) 776-3065

NPI assigned

Jun 25, 2009

Organization subpart

Yes

Parent organization

MEDSHAPE WEIGHT LOSS CLINIC, LLCAs reported in NPPES

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

Authorized official

Name

Ms. Stephanie Smith

Title

Director of Operations

Phone

(480) 276-3742

Specialties & licenses 1

Addresses

Tax ID family

Medshape Weight Loss Clinic LLC3 organizations share this tax ID, including this one

Part of

Medshape Weight Loss Clinic LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Medshape Weight Loss Clinic LLC

  • Clinic/Center
  • Mesa, AZ
  • NPI 1285875039
  NPD tax ID
• Medshape Weight Loss Clinic LLC

  • Medical Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1316178635
  NPD tax ID

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.

• Medshape Weight Loss Clinic LLC

  • Clinic/Center
  • Mesa, AZ
  • NPI 1285875039
  NPPES parent name

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1093943219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7972 W THUNDERBIRD RD",
            "address_2": "106",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814903",
            "telephone_number": "623-412-2700",
            "fax_number": "623-776-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7972 W THUNDERBIRD RD",
            "address_2": "106",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814903",
            "telephone_number": "623-412-2700",
            "fax_number": "623-776-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSHAPE WEIGHT LOSS CLINIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDSHAPE WEIGHT LOSS CLINIC, LLC",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "480-276-3742",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Medical Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.