Northwest Surgical Development of Fresno LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTHWEST SURGICAL DEVELOPMENT OF FRESNO LLC

Doing business as

Athenix Body Sculpting Institute

Practice address

7015 N Maple Ave
Ste 102
Fresno, CA 93720-8010

Phone

(559) 325-7855

NPI assigned

Feb 11, 2015

Organization subpart

No

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

Authorized official

Name

Mr. James Haefner

Title

Administration

Phone

(949) 600-9931

Specialties & licenses 1

Addresses

Other names 1

• Athenix Body Sculpting Institute Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Manuel Gigena, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Scottsdale, AZ
  • NPI 1487834792
  NPD (past)

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1255722336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 ENTERPRISE",
            "address_2": "STE 125",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926562706",
            "telephone_number": "949-600-9931",
            "fax_number": "949-600-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 N MAPLE AVE",
            "address_2": "STE 102",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208010",
            "telephone_number": "559-325-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SURGICAL DEVELOPMENT OF FRESNO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "HAEFNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATION",
        "authorized_official_telephone_number": "949-600-9931",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athenix Body Sculpting Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronald Joseph Northrop, DDS MD
• Jessica Marie Northrup
• Northwest Medical Pharmacy (DBA:Northwest Medical Pharmacy)
• Northwest Optometry Associates, Inc.
• Northwest Physicians Medical Group
• Daniel Proctor Norton
• Matthew Kelly Norton, D.C.
• Norwich Elder Care, LLC
• Paul C Norwood, M.D., F.A.C.P.
• Justin Nou

• Ambulatory Surgical Clinic/Center in Fresno, CA
• Providers in Fresno, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.