Mesa Pain Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MESA PAIN CENTER LLC

Practice address

3850 E Baseline Rd Ste 117
Mesa, AZ 85206-4404

Phone

(480) 712-6663

NPI assigned

Mar 25, 2019

Organization subpart

No

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

Authorized official

Name

Cori Kovac

Title

Owner

Phone

(480) 712-6663

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553472000000",
    "number": "1366902249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 E BASELINE RD STE 117",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064404",
            "telephone_number": "480-712-6663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 E BASELINE RD STE 117",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064404",
            "telephone_number": "480-712-6663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A",
        "authorized_official_last_name": "KOVAC",
        "authorized_official_first_name": "CORI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-712-6663"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mesa Outpatient Treatment Center LLC
• Mesa Pavilions Dental LLC
• Mesa Physical Medicine PLLC
• Mesa Physician Group
• Mesa Public Schools
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• Ambulatory Surgical Clinic/Center in Mesa, AZ
• Providers in Mesa, 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 Mar 25, 2019; 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.