St Peregrine Wound Care LLC

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

ST PEREGRINE WOUND CARE LLC

Practice address

2000 W Bethany Home Rd
Phoenix, AZ 85015-2443

Phone

(602) 246-5576

NPI assigned

Jul 2, 2013

Last updated

Jul 2, 2013By 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

Dr. Marianne Teresa Mason, MDNPI 1467690388

Title

Owner

Phone

(605) 371-6244

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.

• Marianne Teresa Mason, M.D.

  • Obstetrics & Gynecology Physician
  • Sun City, AZ
  • NPI 1467690388
  Authorized official Same address or phone

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1164862371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9551 W COUNTRY CLUB DR",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853731725",
            "telephone_number": "605-371-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152443",
            "telephone_number": "602-246-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PEREGRINE WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-02",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-371-6244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.