NPIMap

Organization Active NPI

Arizona LS LLC

Doing business as Medi-Weightloss

  • Obesity Medicine (Family Medicine) Physician
  • Mount Pleasant, SC
National Provider Identifier
1699157958
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
License
20034883 Issued in SC
Legal business name
ARIZONA LS LLC
Doing business as
Medi-Weightloss
Practice address
966 Houston Northcutt Blvd
Ste G
Mt Pleasant, SC 29464-3487
Phone
(843) 388-6334
Fax
(843) 388-4197
NPI assigned
Jun 23, 2015
Last updated
Jun 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Authorized official

Name
John Kaloust
Title
Manager Member
Phone
(813) 228-6334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Family Medicine) Physician 207QB0002X 20034883 SC Primary

Addresses

Primary practice location

966 Houston Northcutt Blvd
Ste G
Mt Pleasant, SC 29464-3487

Mailing address

509 S Hyde Park Ave
Tampa, FL 33606-2266
Phone (813) 228-6334

Other names 1

  • Medi-Weightloss Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arizona LS LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

966 Houston Northcutt Blvd
Ste G
Mt Pleasant, SC 29464
Phone (843) 388-6334

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1699157958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 S HYDE PARK AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336062266",
            "telephone_number": "813-228-6334",
            "fax_number": "813-228-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 HOUSTON NORTHCUTT BLVD",
            "address_2": "STE G",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643487",
            "telephone_number": "843-388-6334",
            "fax_number": "843-388-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA LS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "KALOUST",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "813-228-6334"
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "SC",
            "license": "20034883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medi-Weightloss",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.