Active NPI
Havasu Regional Medical Center LLC
- Ambulatory Surgical Clinic/Center
- Lake Havasu City, AZ
National Provider Identifier
1467673293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- HAVASU REGIONAL MEDICAL CENTER LLC
- Doing business as
- Havasu Surgery Center
- Practice address
- 1775 McCulloch Blvd N
Lake Havasu City, AZ 86403-6549 - Phone
- (928) 855-8185
- NPI assigned
- May 1, 2007
- Organization subpart
- Yes
- Parent organization
- HAVASU REGIONAL MEDICAL CENTER LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathy J. Teague
- Title
- Secretary
- Phone
- (615) 920-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
1775 McCulloch Blvd N
Lake Havasu City, AZ 86403-6549
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-4536
Phone (615) 920-7000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 231644 | Medicaid | AZ |
Other names 1
- Havasu Surgery Center
National Provider Directory
National Provider Directory- Part of
- Havasu Regional Medical Center LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1564099200000",
"number": "1467673293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 SEVEN SPRINGS WAY",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370274536",
"telephone_number": "615-920-7000",
"fax_number": "615-920-8913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 MCCULLOCH BLVD N",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864036549",
"telephone_number": "928-855-8185"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HAVASU REGIONAL MEDICAL CENTER LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HAVASU REGIONAL MEDICAL CENTER LLC",
"enumeration_date": "2007-05-01",
"last_updated": "2019-07-26",
"status": "A",
"authorized_official_last_name": "TEAGUE",
"authorized_official_first_name": "KATHY",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "615-920-7000"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "231644",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Havasu Surgery Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Havasu Surgery Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lake Havasu City, AZ
- Havasu Primary Care, LTD.
- Havasu Rainbow Pediatrics
- Havasu Rainbow Pediatrics and Associates PLLC
- Havasu Regional Medical Center LLC
- Havasu Regional Medical Center LLC
- Havasu Regional Medical Center LLC
- Havasu Regional Medical Center LLC
- Havasu Regional Medical Center, LLC
- Havasu Regional Medical Center, LLC
- Havasu Surgery Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.