NPIMap

Organization Active NPI

Western Urological Associates, PC

  • Specialist
  • Parker, AZ
National Provider Identifier
1699957332
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
15301 Issued in AZ
Legal business name
WESTERN UROLOGICAL ASSOCIATES, PC
Practice address
601 W Riverside Dr
Suites 3 and 4
Parker, AZ 85344-5119
Phone
(602) 377-5900
NPI assigned
Dec 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Robert S Nickolisen, MDNPI 1487692125
Title
Owner
Phone
(602) 377-5900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 15301 AZ Primary

Addresses

Primary practice location

601 W Riverside Dr
Suites 3 and 4
Parker, AZ 85344-5119

Mailing address

2485 Stroke Dr
Lake Havasu City, AZ 86406-7622
Phone (602) 377-5900

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": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1699957332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 STROKE DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864067622",
            "telephone_number": "602-377-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W RIVERSIDE DR",
            "address_2": "SUITES 3 AND 4",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853445119",
            "telephone_number": "602-377-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN UROLOGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "NICKOLISEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-377-5900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "15301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.