Imperial Synergy LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

IMPERIAL SYNERGY LLC

Practice address

2601 W Dunlap Ave # 206
Phoenix, AZ 85021-2711

Phone

(323) 772-8626

NPI assigned

Dec 9, 2022

Organization subpart

No

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

Authorized official

Name

Derric ThompsonNPI 1609587617

Title

Owner

Phone

(323) 772-8626

Specialties & licenses 1

Addresses

Other names 1

• Imperial Synergy LLC Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derric Thompson

  • Behavior Analyst
  • Phoenix, AZ
  • NPI 1609587617
  NPD Authorized official

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1306557319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 W DUNLAP AVE # 206",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212711",
            "telephone_number": "323-772-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 W DUNLAP AVE # 206",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850212711",
            "telephone_number": "323-772-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL SYNERGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DERRIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-772-8626"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imperial Synergy LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Sherry Imparato, CCC-SLP
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• Marlee Renee Imperiale, M.A. CCC-SLP
• Patrick Impola
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• Karen Michele Imus, RD

• Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.