NPIMap

Organization Active NPI

Southeast Valley Urology PC

  • Urology Physician
  • Mesa, AZ
National Provider Identifier
1235240920
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
SOUTHEAST VALLEY UROLOGY PC
Practice address
6344 E Broadway Rd
Suite 112
Mesa, AZ 85206-1634
Phone
(480) 924-7333
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John Croushore, DONPI 1740260124
Title
Physician
Phone
(480) 924-7333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X Primary

Addresses

Primary practice location

6344 E Broadway Rd
Suite 112
Mesa, AZ 85206-1634

Mailing address

6344 E Broadway Rd
Suite 112
Mesa, AZ 85206-1634
Phone (480) 924-7333

National Provider Directory

National Provider Directory

Locations

6344 E Broadway Rd
Ste 112
Mesa, AZ 85206
Phone (480) 924-7333

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235240920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6344 E BROADWAY RD",
            "address_2": "SUITE 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061634",
            "telephone_number": "480-924-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6344 E BROADWAY RD",
            "address_2": "SUITE 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061634",
            "telephone_number": "480-924-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST VALLEY UROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CROUSHORE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-924-7333",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.