NPIMap

Organization Active NPI

Ahwatukee Sports and Spine PLC

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
National Provider Identifier
1487610218
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
AHWATUKEE SPORTS AND SPINE PLC
Practice address
4530 East Muirwood Drive
Ste 110
Phoenix, AZ 85048
Phone
(480) 763-5808
Fax
(480) 759-0647
NPI assigned
Apr 21, 2006
Last updated
Oct 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Authorized official

Name
Mr. John M Kozak, MDNPI 1609833409
Title
President
Phone
(480) 763-5808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X NU Primary

Addresses

Primary practice location

4530 East Muirwood Drive
Ste 110
Phoenix, AZ 85048

Mailing address

PO Box 52817
Phoenix, AZ 85072-2817
Phone (480) 763-5808

National Provider Directory

National Provider Directory

Locations

4530 E Muirwood Dr
Phoenix, AZ 85048
Phone (480) 610-6981

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1487610218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52817",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850722817",
            "telephone_number": "480-763-5808",
            "fax_number": "480-759-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 EAST MUIRWOOD DRIVE",
            "address_2": "STE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85048",
            "telephone_number": "480-763-5808",
            "fax_number": "480-759-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHWATUKEE SPORTS AND SPINE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "KOZAK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-763-5808",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.