Ryan Alec Anesthesia , PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

RYAN ALEC ANESTHESIA , PLLC

Practice address

7600 N 15TH St
Phoenix, AZ 85020-4327

Phone

(915) 240-2709

NPI assigned

Jul 7, 2021

Last updated

Jul 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vanessa Koziol

Title

Credentialing

Phone

(480) 376-6456

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1679144000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39179",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850699179",
            "telephone_number": "602-395-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 15TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204327",
            "telephone_number": "915-240-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN ALEC ANESTHESIA , PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "KOZIOL",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "480-376-6456"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PEND",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@eamedbill.com",
            "affiliation": "N",
            "address_1": "7600 N 15th St",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850204327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Anesthesiology Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Anesthesiology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.