NPIMap

Organization Active NPI

Desert Spine Surgeons, PC

  • Orthopaedic Surgery of the Spine Physician
  • Surprise, AZ
National Provider Identifier
1174701643
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
DESERT SPINE SURGEONS, PC
Practice address
12361 W Bola Dr
Suite 100
Surprise, AZ 85378-9021
Phone
(623) 584-5626
Fax
(623) 544-9122
NPI assigned
Feb 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Authorized official

Name
Robert C. Waldrip, M. D.
Title
Physician
Phone
(623) 584-5626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

12361 W Bola Dr
Suite 100
Surprise, AZ 85378-9021

Mailing address

12361 W Bola Dr
Suite 100
Surprise, AZ 85378-9021
Phone (623) 584-5626

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1174701643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12361 W BOLA DR",
            "address_2": "SUITE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789021",
            "telephone_number": "623-584-5626",
            "fax_number": "623-544-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12361 W BOLA DR",
            "address_2": "SUITE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789021",
            "telephone_number": "623-584-5626",
            "fax_number": "623-544-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT SPINE SURGEONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "WALDRIP",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "623-584-5626",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.