NPIMap

Organization Active NPI

Phoenix Perfusion Services

  • Perfusionist
  • Mesa, AZ
National Provider Identifier
1245372580
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PerfusionistTaxonomy code 242T00000X
Legal business name
PHOENIX PERFUSION SERVICES
Practice address
1830 S Alma School Rd
Suite 108
Mesa, AZ 85210-3056
Phone
(480) 248-3070
Fax
(480) 248-3099
NPI assigned
Feb 13, 2007
Last updated
May 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Mrs. Machelle A Shook
Title
Director of Operations
Phone
(480) 248-3070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perfusionist 242T00000X NU Primary

Addresses

Primary practice location

1830 S Alma School Rd
Suite 108
Mesa, AZ 85210-3056

Mailing address

1830 S Alma School Rd
Suite 108
Mesa, AZ 85210-3056
Phone (480) 248-3070

Other identifiers 2

IdentifierTypeStateIssuer
126922OtherAZHEALTHNET
AZ0725920OtherAZBCBS OF AZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1245372580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 S ALMA SCHOOL RD",
            "address_2": "SUITE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103056",
            "telephone_number": "480-248-3070",
            "fax_number": "480-248-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 S ALMA SCHOOL RD",
            "address_2": "SUITE 108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103056",
            "telephone_number": "480-248-3070",
            "fax_number": "480-248-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PERFUSION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "SHOOK",
        "authorized_official_first_name": "MACHELLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "480-248-3070",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "126922",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AZ",
            "identifier": "AZ0725920",
            "state": "AZ"
        }
    ],
    "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 May 17, 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.