Restore DME Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

30153 Issued in AZ

Legal business name

RESTORE DME MEDICAL GROUP, LLC

Practice address

6410 S Kings Ranch Rd
Ste 1
Gold Canyon, AZ 85118-7352

Phone

(480) 689-9205

Fax

(480) 288-2879

NPI assigned

Mar 11, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Robert Christiaan Allen, M.D.

Title

Owner

Phone

(480) 689-9205

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457654400000",
    "number": "1104287697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD",
            "address_2": "STE 1",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187352",
            "telephone_number": "480-689-9205",
            "fax_number": "480-288-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD",
            "address_2": "STE 1",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187352",
            "telephone_number": "480-689-9205",
            "fax_number": "480-288-2879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE DME MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CHRISTIAAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-689-9205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "30153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Gold Canyon, AZ
• Providers in Gold Canyon, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.