Organization Active NPI

Sycamoresoul L.L.C.

  • Durable Medical Equipment & Medical Supplies
  • Sedona, AZ
National Provider Identifier
1356679286
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SYCAMORESOUL L.L.C.
Practice address
55 Shelby Dr
A-3
Sedona, AZ 86336-5300
Phone
(928) 282-3535
Fax
(928) 282-1107
NPI assigned
Dec 4, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Authorized official

Name
Mr. Steve W Livanavage Jr.
Title
President
Phone
(928) 282-3535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

55 Shelby Dr
A-3
Sedona, AZ 86336-5300

Mailing address

55 Shelby Dr
A-3
Sedona, AZ 86336-5300
Phone (928) 282-3535

Other names 1

  • sedonamedplus Doing business as

National Provider Directory

National Provider Directory

Locations

55 Shelby Dr
Ste A3
Sedona, AZ 86336
Phone (928) 282-3535

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259884800000",
    "number": "1356679286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SHELBY DR",
            "address_2": "A-3",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365300",
            "telephone_number": "928-282-3535",
            "fax_number": "928-282-1107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SHELBY DR",
            "address_2": "A-3",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863365300",
            "telephone_number": "928-282-3535",
            "fax_number": "928-282-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCAMORESOUL L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-04",
        "last_updated": "2009-12-04",
        "status": "A",
        "authorized_official_last_name": "LIVANAVAGE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-282-3535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "sedonamedplus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sedona, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.