Organization Active NPI

Surprise Family Medicine PLC

  • Family Medicine Physician
  • Surprise, AZ
National Provider Identifier
1548591886
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
005062 Issued in AZ
Legal business name
SURPRISE FAMILY MEDICINE PLC
Practice address
14239 W Bell Rd
Ste 225
Surprise, AZ 85374-2469
Phone
(623) 544-0101
Fax
(623) 544-0981
NPI assigned
Jan 27, 2010
Last updated
Jun 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Steven C Horrocks, DONPI 1932225802
Title
Member
Phone
(623) 544-0101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 005062 AZ Primary

Addresses

Primary practice location

14239 W Bell Rd
Ste 225
Surprise, AZ 85374-2469

Mailing address

PO Box 9311
Belfast, ME 04915-9311
Phone (623) 544-0101

Other identifiers 1

IdentifierTypeStateIssuer
507833MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100928001659 AZ Part B Supplier - Clinic/Group Practice 1456477348 Receives reassigned benefits from 1 practitioner
Practice locations: Surprise, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2003118Surprise Family Medicine, PLC14239 W Bell Rd, Ste 225, Surprise, AZ 85374Provider-performed microscopyFeb 1, 2028

National Provider Directory

National Provider Directory

Locations

14239 W Bell Rd
Ste 225
Surprise, AZ 85374
Phone (623) 544-0101

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2359/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1264550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1548591886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9311",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049159311",
            "telephone_number": "623-544-0101",
            "fax_number": "623-544-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14239 W BELL RD",
            "address_2": "STE 225",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742469",
            "telephone_number": "623-544-0101",
            "fax_number": "623-544-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURPRISE FAMILY MEDICINE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "HORROCKS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "623-544-0101",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "005062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507833",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.