Associated Desert Gastroenterologists PC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

12854 Issued in AZ

Legal business name

ASSOCIATED DESERT GASTROENTEROLOGISTS PC

Practice address

215 S Power Rd
# 102
Mesa, AZ 85206-5235

Phone

(480) 985-9005

Fax

(480) 396-9974

NPI assigned

Nov 15, 2007

Last updated

Nov 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Prem C Kumar, MDNPI 1700841350

Title

Owner

Phone

(480) 985-9005

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Prem C Kumar, MD

  • Gastroenterology Physician
  • Mesa, AZ
  • NPI 1700841350
  Authorized official Same address or phone

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1336320613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S POWER RD",
            "address_2": "SUITE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065235",
            "telephone_number": "480-985-9005",
            "fax_number": "480-396-9974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S POWER RD",
            "address_2": "# 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065235",
            "telephone_number": "480-985-9005",
            "fax_number": "480-396-9974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED DESERT GASTROENTEROLOGISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "PREM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-985-9005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "12854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "0002430",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Gastroenterology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; 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.