Irc DC Az, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

IRC DC AZ, LLC

Practice address

14780 W Mountain View Blvd Ste 109
Surprise, AZ 85374-7280

Phone

(623) 240-1110

NPI assigned

Mar 11, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Arvind Durvasan

Title

Owner

Phone

(623) 240-1110

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Locations

Practitioners 3

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

• Linh C Nguyen, M.D., M.S., CPE

  • Adult Medicine Physician
  • Surprise, AZ
  • NPI 1275596827
  NPD (past)
• Gloria Nyakerario Obaigwa

  • Adult Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1386223329
  NPD (past)
• Steven Frederick Legate, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Lomira, WI
  • NPI 1245872761
  NPD (past)

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583884800000",
    "number": "1386279255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD STE 109",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747280",
            "telephone_number": "623-240-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD STE 109",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747280",
            "telephone_number": "623-240-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRC DC AZ, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A",
        "authorized_official_last_name": "DURVASAN",
        "authorized_official_first_name": "ARVIND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-240-1110",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "830265",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@sipmd.com",
            "affiliation": "N",
            "address_1": "14780 W Mountain View Blvd Ste 109",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853747280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@sipmd.com",
            "affiliation": "N",
            "address_1": "14780 W Mountain View Blvd Ste 109",
            "city": "Surprise",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853747280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nephrology Physician in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Nephrology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.