Carondelet St. Mary'S Northwest, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC3857 Issued in AZ

Legal business name

CARONDELET ST. MARY'S NORTHWEST, LLC

Practice address

2220 W Orange Grove Rd
Tucson, AZ 85741-3117

Phone

(520) 877-5660

Fax

(520) 877-5669

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Jenetha D Moran

Title

Officer / Authorized Official

Phone

(972) 763-3893

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Carondelet Foothills Surgery Center Doing business as

Listed as

Carondelet St Marys Northwest LLC Dba Carondelet Foothills Surgery CenterCCN 03C0001289

Medicare certification status

ActiveFrom the Provider of Services file

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Locations

Practitioners 1

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

• David A Parry, MD

  • Otolaryngology Physician
  • Tucson, AZ
  • NPI 1114990892
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1487716650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 W ORANGE GROVE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413117",
            "telephone_number": "520-877-5660",
            "fax_number": "520-877-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 W ORANGE GROVE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413117",
            "telephone_number": "520-877-5660",
            "fax_number": "520-877-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARONDELET ST. MARY'S NORTHWEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "JENETHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICER / AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "972-763-3893"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC3857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006486",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "03C0001289",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carondelet Foothills Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carondelet Medical Group Urgent Care, Inc
• Carondelet Medical Group, Inc
• Carondelet Specialist Group, Inc
• Carondelet St Marys Campus LLC
• Carondelet St. Joseph'S Hospital
• Cathy P. Carpenter, M.D.
• Heidi Ana Carpenter, OTD, OTR/L
• Sarah Jane Carpenter, M.D.
• Trena Britven Carpenter, D.D.S.
• Matthew David Carpinello, MD

• Ambulatory Surgical Clinic/Center in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.