Phoenix Premiere Pain, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC 4400 Issued in AZ

Legal business name

PHOENIX PREMIERE PAIN, LLC

Practice address

6245 N 16TH St
Phoenix, AZ 85016-1706

Phone

(602) 253-4271

Fax

(214) 872-3387

NPI assigned

Oct 24, 2014

Organization subpart

No

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

Authorized official

Name

Lynn Dugger

Title

Director of Operations

Phone

(214) 872-3381

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1336544964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 PRESTON RD STE 295",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346422",
            "telephone_number": "214-872-3381",
            "fax_number": "214-872-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850161706",
            "telephone_number": "602-253-4271",
            "fax_number": "214-872-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PREMIERE PAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "DUGGER",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "214-872-3381"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC 4400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.