NPIMap

Organization Active NPI

CD Healthcare,LLC

  • Physical Medicine & Rehabilitation Physician
  • Mesa, AZ
National Provider Identifier
1619399714
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
CD HEALTHCARE,LLC
Practice address
4540 E Baseline Rd
Suite 105
Mesa, AZ 85206-4613
Phone
(480) 272-8944
Fax
(480) 237-5682
NPI assigned
Jan 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Authorized official

Name
Craig Defries, DC
Title
Manager
Phone
(480) 272-8944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

4540 E Baseline Rd
Suite 105
Mesa, AZ 85206-4613

Mailing address

4540 E Baseline Rd
Suite 105
Mesa, AZ 85206-4613
Phone (480) 272-8944

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389225600000",
    "number": "1619399714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD",
            "address_2": "SUITE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064613",
            "telephone_number": "480-272-8944",
            "fax_number": "480-237-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 E BASELINE RD",
            "address_2": "SUITE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064613",
            "telephone_number": "480-272-8944",
            "fax_number": "480-237-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CD HEALTHCARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A",
        "authorized_official_last_name": "DEFRIES",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "480-272-8944",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "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 Jan 9, 2014; 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.