Prime Surgical Assisting, LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

P-1257205-6 Issued in AZ

Legal business name

PRIME SURGICAL ASSISTING, LLC

Practice address

2905 W Warner Rd Ste 1
Chandler, AZ 85224-1674

Phone

(480) 603-9000

NPI assigned

May 23, 2006

Last updated

Mar 27, 2018By 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

Mr. Gary Trent Fullmer, PA-C

Title

Owner

Phone

(480) 216-2231

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Melanie Denise Deyoung, PA-C

  • Physician Assistant
  • Gilbert, AZ
  • NPI 1467406264

  Surgical

  NPD
• Julie Allen Kennedy, PAC

  • Physician Assistant
  • Gilbert, AZ
  • NPI 1437120144

  Surgical

  NPD

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1528013364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 E COTTON CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852344330",
            "telephone_number": "480-216-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 W WARNER RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852241674",
            "telephone_number": "480-603-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME SURGICAL ASSISTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "FULLMER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "TRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-216-2231",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "P-1257205-6",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Jay Priest
• Christine Rose Prigge, OT
• Primary Care Associates PLLC
• Prime Care Express LLC
• Prime Health Solutions LLC
• Danielle Davida Prince Rosenkrans, MD
• Sarah Prise
• Prism Hospice, LLC (Prism Hospice)
• Heather Pritchard, PHARM D
• Renee Jeanine Privett, PA-C

• Surgical Physician Assistant in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.