Organization Active NPI

Cedar Ridge Rheumatology PLLC

  • Medical Specialty Clinic/Center
  • Lakeside, AZ
National Provider Identifier
1306766274
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
CEDAR RIDGE RHEUMATOLOGY PLLC
Practice address
1355 W White Mountain Blvd Ste a
Lakeside, AZ 85929-7068
Phone
(928) 358-5200
Fax
(928) 358-5170
NPI assigned
Jul 20, 2026
Last updated
Aug 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Mr. Jason Pace, PA
Title
Owner
Phone
(210) 632-2807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU Primary

Addresses

Primary practice location

1355 W White Mountain Blvd Ste a
Lakeside, AZ 85929-7068

Mailing address

1355 W White Mountain Blvd Ste a
Lakeside, AZ 85929-7068
Phone (480) 440-8696

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1784505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1306766274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 W WHITE MOUNTAIN BLVD STE A",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859297068",
            "telephone_number": "480-440-8696",
            "fax_number": "928-358-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 W WHITE MOUNTAIN BLVD STE A",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859297068",
            "telephone_number": "928-358-5200",
            "fax_number": "928-358-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR RIDGE RHEUMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-20",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-632-2807",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeside, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; 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.