Arizona Mobile Dermatology and Wound Care PLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ARIZONA MOBILE DERMATOLOGY AND WOUND CARE PLC

Practice address

7301 E 2ND St Ste 200
Scottsdale, AZ 85251-5610

Phone

(602) 418-8766

NPI assigned

Nov 18, 2019

Last updated

Mar 7, 2023By 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

Neil Peter Superfon, D.ONPI 1588610422

Title

Owner/Provider

Phone

(602) 417-8766

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Neil P. Superfon, D.O.

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1588610422
  NPD Authorized official
• Rick A Shacket, DO MD H

  • Colon & Rectal Surgery Physician
  • Scottsdale, AZ
  • NPI 1467537159

  Dermatology

  NPD

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1548806276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6535 N ARIZONA BILTMORE CIR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168907",
            "telephone_number": "602-417-8766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 E 2ND ST STE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852515610",
            "telephone_number": "602-418-8766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6535 N Arizona Biltmore Cir",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850168907",
            "country_code": "US",
            "telephone_number": "602-418-8766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7615 W Thunderbird Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853816083",
            "country_code": "US",
            "telephone_number": "602-417-8766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARIZONA MOBILE DERMATOLOGY AND WOUND CARE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2023-03-07",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "SUPERFON",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "602-417-8766",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ MEDICAL LICENSE NUMBER",
            "identifier": "0754",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.