NPIMap

Organization Active NPI

Sun Valley Surgical Physician Assistant, LLC

  • Surgical Physician Assistant
  • Peoria, AZ
National Provider Identifier
1669855193
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
3332 Issued in AZ
Legal business name
SUN VALLEY SURGICAL PHYSICIAN ASSISTANT, LLC
Practice address
9031 W Runion Dr
Peoria, AZ 85382-6472
Phone
(623) 810-7539
NPI assigned
Jul 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Authorized official

Name
Jennifer Speer, PA
Title
Physician Assistant
Phone
(623) 810-7539

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X 3332 AZ Primary

Addresses

Primary practice location

9031 W Runion Dr
Peoria, AZ 85382-6472

Mailing address

9031 W Runion Dr
Peoria, AZ 85382-6472
Phone (623) 810-7539

National Provider Directory

National Provider Directory

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": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1669855193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9031 W RUNION DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853826472",
            "telephone_number": "623-810-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9031 W RUNION DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853826472",
            "telephone_number": "623-810-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN VALLEY SURGICAL PHYSICIAN ASSISTANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "SPEER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "623-810-7539",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "3332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.