NPIMap

Organization Active NPI

Sun Valley Internist LLC

  • Non-Pharmacy Dispensing Site
  • Sun City, AZ
National Provider Identifier
1194146555
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
16317 Issued in AZ
Legal business name
SUN VALLEY INTERNIST LLC
Practice address
14815 N del Webb Blvd
#2
Sun City, AZ 85351-2145
Phone
(623) 977-3300
NPI assigned
Jan 2, 2014
Last updated
Jan 2, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Kenny Heine
Title
VP of Operations
Phone
(858) 964-1506

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 16317 AZ Primary

Addresses

Primary practice location

14815 N del Webb Blvd
#2
Sun City, AZ 85351-2145

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

National Provider Directory

National Provider Directory
Part of
Medvantx Inc

Locations

14815 N Del Webb Blvd
#2
Sun City, AZ 85351
Phone (602) 977-3300

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1194146555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14815 N DEL WEBB BLVD",
            "address_2": "#2",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853512145",
            "telephone_number": "623-977-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN VALLEY INTERNIST LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "AZ",
            "license": "16317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.