Organization Active NPI

Bdpec Show Low ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Show Low, AZ
National Provider Identifier
1366756579
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
BDPEC SHOW LOW ASC LLC
Practice address
1500 S White Mountain Rd
Suite 300
Show Low, AZ 85901-7111
Phone
(928) 537-3937
Fax
(928) 537-4729
NPI assigned
Jul 29, 2010
Last updated
Jul 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Authorized official

Name
Donald G Snyder
Title
Cfo
Phone
(602) 955-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X AZ Primary

Addresses

Primary practice location

1500 S White Mountain Rd
Suite 300
Show Low, AZ 85901-7111

Mailing address

4800 N 22ND St
Phoenix, AZ 85016-4701
Phone (602) 955-1000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1366756579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N 22ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164701",
            "telephone_number": "602-955-1000",
            "fax_number": "602-508-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S WHITE MOUNTAIN RD",
            "address_2": "SUITE 300",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017111",
            "telephone_number": "928-537-3937",
            "fax_number": "928-537-4729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BDPEC SHOW LOW ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-955-1000"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; 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.