Sierra Gastroenterology, PLLC.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SIERRA GASTROENTEROLOGY, PLLC.

Practice address

4990 E Mediterranean Dr
Suite a
Sierra Vista, AZ 85635-2494

Phone

(520) 458-5890

Fax

(520) 458-4439

NPI assigned

Apr 23, 2012

Organization subpart

No

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

Authorized official

Name

Vijaya D Boyella, MD

Title

President

Phone

(520) 458-5890

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1114285566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4990 E MEDITERRANEAN DR",
            "address_2": "SUITE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352494",
            "telephone_number": "520-458-5890",
            "fax_number": "520-458-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4990 E MEDITERRANEAN DR",
            "address_2": "SUITE A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352494",
            "telephone_number": "520-458-5890",
            "fax_number": "520-458-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA GASTROENTEROLOGY, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "BOYELLA",
        "authorized_official_first_name": "VIJAYA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-458-5890",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168213",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "35086",
            "identifier": "35086",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley a Auchincloss Otr PC
• Travis Shore, DMD
• Elizabeth Amber Shuey, SLPA
• Hortensia Shute
• Sierra Compounding LLC
• Sierra Hearing Center LLC
• Sierra Heart, PLLC
• Sierra Pharmacy LLC
• Sierra Therapy Solutions LLC
• Sierra Vista Anesthesia LLC

• Internal Medicine Physician in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; 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.