Organization Active NPI

Flying Pig Offroad PLLC

  • Colon & Rectal Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1609518976
Registry record updated Jan 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
FLYING PIG OFFROAD PLLC
Practice address
20333 N 19TH Ave Ste 230
Phoenix, AZ 85027-9901
Phone
(480) 707-9504
Fax
(602) 581-7764
NPI assigned
Apr 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2025

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

Authorized official

Name
Dr. Debora McClary, MD
Title
Owner
Phone
(480) 707-9504

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Colon & Rectal Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208C00000X Primary

Addresses

Primary practice location

20333 N 19TH Ave Ste 230
Phoenix, AZ 85027-9901

Mailing address

PO Box 10356
Glendale, AZ 85318-0356
Phone (480) 707-9504

Other practice location 1

7776 W Quail Ave
Peoria, AZ 85382-3322
Phone (602) 421-1299

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736035200000",
    "number": "1609518976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10356",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853180356",
            "telephone_number": "480-707-9504",
            "fax_number": "602-581-7764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20333 N 19TH AVE STE 230",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850279901",
            "telephone_number": "480-707-9504",
            "fax_number": "602-581-7764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7776 W Quail Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853823322",
            "country_code": "US",
            "telephone_number": "602-421-1299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLYING PIG OFFROAD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2025-01-05",
        "certification_date": "2025-01-05",
        "status": "A",
        "authorized_official_last_name": "MCCLARY",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-707-9504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "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 Jan 5, 2025; 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.