NPIMap

Organization Active NPI

Grand Canyon Perfusion, Inc.

  • Surgical Technologist
  • Mesa, AZ
National Provider Identifier
1659373322
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
Legal business name
GRAND CANYON PERFUSION, INC.
Practice address
2753 E Broadway Rd
#101-454
Mesa, AZ 85204-1579
Phone
(480) 659-6964
Fax
(480) 659-6791
NPI assigned
Aug 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Mark Christenson
Title
Office Manager
Phone
(480) 659-6964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZS0410X Primary

Addresses

Primary practice location

2753 E Broadway Rd
#101-454
Mesa, AZ 85204-1579

Mailing address

PO Box 27588
Tempe, AZ 85285-7588
Phone (480) 777-0607

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659373322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27588",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852857588",
            "telephone_number": "480-777-0607",
            "fax_number": "480-777-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2753 E BROADWAY RD",
            "address_2": "#101-454",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852041579",
            "telephone_number": "480-659-6964",
            "fax_number": "480-659-6791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND CANYON PERFUSION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-659-6964",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "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 Aug 22, 2020; 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.