DVM Pain Group PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP3870 Issued in AZ

Legal business name

DVM PAIN GROUP PLLC

Practice address

18205 N 51St Ave
Suite 113
Glendale, AZ 85308-1490

Phone

(602) 354-4370

Fax

(602) 354-4370

NPI assigned

Feb 4, 2014

Last updated

Feb 4, 2014By 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

Mrs. Vicki Mancuso

Title

Office Administrator

Phone

(480) 510-3567

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1518381060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18205 N 51ST AVE",
            "address_2": "SUITE 113",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081490",
            "telephone_number": "602-354-4370",
            "fax_number": "602-354-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18205 N 51ST AVE",
            "address_2": "SUITE 113",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081490",
            "telephone_number": "602-354-4370",
            "fax_number": "602-354-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DVM PAIN GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "MANCUSO",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "480-510-3567",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiemeka Ifesinachi Duru, DPT
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• William Charles Dykes, M.D.
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• Ashlyn Dzialo, RBT

• Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; 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.