Comprehensive Interventional Care Centers, PLLC

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC

Practice address

2301 N 4TH St
Flagstaff, AZ 86004

Phone

(928) 719-7400

Fax

(480) 371-1121

NPI assigned

Jul 24, 2018

Organization subpart

Yes

Parent organization

COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLCAs reported in NPPES

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

Authorized official

Name

Joel R. Rainwater, MD

Title

President

Phone

(480) 374-7354

Specialties & licenses 2

Addresses

Other names 1

• Comprehensive Interventional Care Centers, PLLC - Flagstaff Doing business as

Part of

Comp Int Care CTRS PLLC

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1235616152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 107",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342744",
            "telephone_number": "480-374-7354",
            "fax_number": "480-371-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N 4TH ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86004",
            "telephone_number": "928-719-7400",
            "fax_number": "480-371-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMPREHENSIVE INTERVENTIONAL CARE CENTERS,  PLLC",
        "enumeration_date": "2018-07-24",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "RAINWATER",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-374-7354",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Interventional Care Centers, PLLC - Flagstaff",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Vascular & Interventional Radiology Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Vascular & Interventional Radiology Physician in Arizona

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