NPIMap

Organization Active NPI

Southwest Matrix Anesthesia PLLC

  • Anesthesiology Physician
  • Phoenix, AZ
National Provider Identifier
1609434331
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SOUTHWEST MATRIX ANESTHESIA PLLC
Practice address
10810 N Tatum Blvd Ste 102302
Phoenix, AZ 85028-0503
Phone
(602) 867-6045
Fax
(888) 423-9465
NPI assigned
May 29, 2019
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Eric J Church, MDNPI 1366419269
Title
Manager
Phone
(480) 265-0890

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

10810 N Tatum Blvd Ste 102302
Phoenix, AZ 85028-0503

Mailing address

2801 Centerville Road, First Floor
PMB 640
Wilmington, DE 19808

Other practice location 1

10810 N Tatum Blvd Ste 103-302
Phoenix, AZ 85028-6055
Phone (602) 740-1333

National Provider Directory

National Provider Directory

Locations

10810 N Tatum Blvd
Ste 103302
Phoenix, AZ 85028
Phone (602) 740-1333

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": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1609434331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 CENTERVILLE ROAD, FIRST FLOOR",
            "address_2": "PMB 640",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10810 N TATUM BLVD STE 102302",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850280503",
            "telephone_number": "602-867-6045",
            "fax_number": "888-423-9465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10810 N Tatum Blvd Ste 103-302",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850286055",
            "country_code": "US",
            "telephone_number": "602-740-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHWEST MATRIX ANESTHESIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-265-0890",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.