16TH Street Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

16TH STREET SURGERY CENTER, LLC

Practice address

6245 N 16TH St
Phoenix, AZ 85016-1706

Phone

(480) 766-6819

NPI assigned

Feb 22, 2019

Organization subpart

No

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

Authorized official

Name

Grant Cook

Title

Owner/Manager

Phone

(480) 766-6819

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550793600000",
    "number": "1629535950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15333 N PIMA RD STE 305",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850161706",
            "telephone_number": "480-766-6819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "16TH STREET SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "480-766-6819"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.