David a Vertullo MD PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

34938 Issued in AZ

Legal business name

DAVID A VERTULLO MD PC

Practice address

1930 E Thomas Rd
Phoenix, AZ 85016-7711

Phone

(480) 596-8525

Fax

(480) 596-8522

NPI assigned

Jun 22, 2006

Last updated

Oct 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Anthony Vertullo, M.D.NPI 1366412462

Title

Owner

Phone

(480) 596-8525

Specialties & licenses 1

Addresses

Other identifiers 4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David A Vertullo, MD

  • Specialist
  • Scottsdale, AZ
  • NPI 1366412462
  Authorized official Same address or phone

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1427094952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26904",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850686904",
            "telephone_number": "480-596-8525",
            "fax_number": "480-596-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167711",
            "telephone_number": "480-596-8525",
            "fax_number": "480-596-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A VERTULLO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "VERTULLO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-596-8525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "34938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109820",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0440730",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "PENDING",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "ZA5362",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ayesha Davenport, MA, LPC
• Brittainy Davenport
• Chris Davenport
• Ginger A. Davenport, RN.
• Stephanie Davenport, LMSW
• David a. Patterson DDS LLC
• David a. Pearman, D.D.S.,P.C.
• David C Johnson MD PC
• David C. Zeman, M.D., P.C.
• David Crowell MD LTD

• Specialist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.