Active NPI
Agave Matrix LLC
- Anesthesiology Physician
- Chandler, AZ
National Provider Identifier
1578074209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- AGAVE MATRIX LLC
- Practice address
- 1100 S Dobson Rd Ste 204
Chandler, AZ 85286-6160 - Phone
- (602) 582-5233
- NPI assigned
- Oct 20, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Polly Pollman
- Title
- Admin
- Phone
- (602) 582-5233
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
1100 S Dobson Rd Ste 204
Chandler, AZ 85286-6160
Mailing address
2801 Centerville Road, PMB 650
Wilmington, DE 19808
National Provider Directory
National Provider DirectoryLocations
1100 S Dobson Rd
Ste 204
Chandler, AZ 85286
Phone (602) 582-5233
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508457600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1508457600000",
"number": "1578074209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 CENTERVILLE ROAD, PMB 650",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "19808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 S DOBSON RD STE 204",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852866160",
"telephone_number": "602-582-5233"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AGAVE MATRIX LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-10-20",
"last_updated": "2017-10-20",
"status": "A",
"authorized_official_last_name": "POLLMAN",
"authorized_official_first_name": "POLLY",
"authorized_official_title_or_position": "ADMIN",
"authorized_official_telephone_number": "602-582-5233"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.