Progressive General Anesthetics, LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

30267 Issued in AZ

Legal business name

PROGRESSIVE GENERAL ANESTHETICS, LLC

Doing business as

George R Edelen MD

Practice address

7600 N 16TH St
Suite 150
Phoenix, AZ 85020-4431

Phone

(602) 395-0718

Fax

(602) 277-8146

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Shannon White

Title

Office Manager

Phone

(602) 443-2325

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• George R Edelen MD Doing business as

Locations

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282003200000",
    "number": "1518902170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39179",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850699179",
            "telephone_number": "602-395-0718",
            "fax_number": "602-277-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 16TH ST",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204431",
            "telephone_number": "602-395-0718",
            "fax_number": "602-277-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE GENERAL ANESTHETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-08-17",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "602-443-2325"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "AZ",
            "license": "30267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "707698",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "George R Edelen MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Anesthesiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.