Organization Active NPI

Stellar Physical Medicine, PLLC

  • General Practice Physician
  • Scottsdale, AZ
National Provider Identifier
1568720837
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
34046 Issued in AZ
Legal business name
STELLAR PHYSICAL MEDICINE, PLLC
Practice address
9301 E Shea Blvd
Ste. 118
Scottsdale, AZ 85260-6733
Phone
(480) 423-3525
Fax
(866) 738-0810
NPI assigned
Apr 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Authorized official

Name
Kathy Wright
Title
Office Manager
Phone
(480) 423-3525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 34046 AZ Primary

Addresses

Primary practice location

9301 E Shea Blvd
Ste. 118
Scottsdale, AZ 85260-6733

Mailing address

9301 E Shea Blvd
Ste. 118
Scottsdale, AZ 85260-6733
Phone (480) 423-3525

Other identifiers 1

IdentifierTypeStateIssuer
1962573139OtherAZNPI

National Provider Directory

National Provider Directory

Locations

9301 E Shea Blvd
Ste 118
Scottsdale, AZ 85260
Phone (480) 423-3525

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1568720837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 E SHEA BLVD",
            "address_2": "STE. 118",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606733",
            "telephone_number": "480-423-3525",
            "fax_number": "866-738-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 E SHEA BLVD",
            "address_2": "STE. 118",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606733",
            "telephone_number": "480-423-3525",
            "fax_number": "866-738-0810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR PHYSICAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-05-07",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-423-3525"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "AZ",
            "license": "34046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962573139",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2012; 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.