Antiaging and Wellness Institute, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

AZ34602 Issued in AZ

Legal business name

ANTIAGING AND WELLNESS INSTITUTE, PLLC

Practice address

4141 N Goldwater Blvd Ste 102
Scottsdale, AZ 85251-3848

Phone

(480) 947-2873

NPI assigned

Aug 7, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Helen R Ross, M.D.NPI 1922164714

Title

Physician/Owner

Phone

(480) 947-2873

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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

• Helen R Ross, M.D.

  • Dermatology Physician
  • Casa Grande, AZ
  • NPI 1922164714
  Medicare reassignment NPD Authorized official
• Andrew Joseph Racette, D.O.

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1447429097
  Medicare reassignment

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

{
    "created_epoch": "1375833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1376975748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 N GOLDWATER BLVD STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513848",
            "telephone_number": "480-947-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 N GOLDWATER BLVD STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513848",
            "telephone_number": "480-947-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIAGING AND WELLNESS INSTITUTE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-07",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "480-947-2873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "AZ34602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Camille Marie Antieau-Olson
• Melissa Ann Antognini, WHNP
• Nicole Christine Antol, DDS
• Aster Moriah Antolik, RN
• Mojdeh Anvari Tehrani, D.D.S

• Dermatology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.