Convertabath, Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

259082 Issued in AZ

Legal business name

CONVERTABATH, INC.

Practice address

1605 W University Dr
Suite 109
Tempe, AZ 85281-3267

Phone

(480) 646-1348

Fax

(480) 446-7015

NPI assigned

Jan 27, 2011

Organization subpart

No

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

Authorized official

Name

Jeannine S Dinges

Title

President

Phone

(480) 656-1348

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1316243058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 W UNIVERSITY DR",
            "address_2": "SUITE 109",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852813267",
            "telephone_number": "480-646-1348",
            "fax_number": "480-446-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 W UNIVERSITY DR",
            "address_2": "SUITE 109",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852813267",
            "telephone_number": "480-646-1348",
            "fax_number": "480-446-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVERTABATH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "DINGES",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-656-1348"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "AZ",
            "license": "259082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE RESALE BUSINESS LICENSE",
            "identifier": "20096376",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA REGISTRAR OF CONTRACTORS LICENSE",
            "identifier": "259082",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.