NPIMap

Organization Active NPI

Comprehensive Interventional Care Centers, PLLC

  • Primary Care Clinic/Center
  • Mesa, AZ
National Provider Identifier
1548856164
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC
Practice address
130 S 63Rd St Ste 101
Mesa, AZ 85206-1620
Phone
(480) 985-6000
Fax
(480) 985-8641
NPI assigned
Dec 17, 2020
Last updated
Dec 17, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Authorized official

Name
Joel R. Rainwater, MDNPI 1518956499
Title
Ceo, Cmo
Phone
(480) 374-7354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0204X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

130 S 63Rd St Ste 101
Mesa, AZ 85206-1620

Mailing address

4001 E Baseline Rd Ste 107
Gilbert, AZ 85234-2744
Phone (480) 374-7354

National Provider Directory

National Provider Directory
Part of
Comp Int Care CTRS PLLC

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

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": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1548856164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 E BASELINE RD STE 107",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342744",
            "telephone_number": "480-374-7354",
            "fax_number": "480-371-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S 63RD ST STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061620",
            "telephone_number": "480-985-6000",
            "fax_number": "480-985-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMPREHENSIVE INTERVENTIONAL CARE CENTERS, PLLC",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "RAINWATER",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO, CMO",
        "authorized_official_telephone_number": "480-374-7354",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.