NPIMap

Organization Active NPI

Arizona Medical Spine Institute

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Phoenix, AZ
National Provider Identifier
1700910270
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
20012 Issued in AZ
Legal business name
ARIZONA MEDICAL SPINE INSTITUTE
Practice address
4530 E Ray Rd
Suite 150
Phoenix, AZ 85044-6094
Phone
(480) 503-3344
Fax
(480) 763-0417
NPI assigned
Mar 15, 2007
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
Dr. Randall PruittNPI 1164565131
Title
President
Phone
(480) 503-3344

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
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X 20012 AZ Primary

Addresses

Primary practice location

4530 E Ray Rd
Suite 150
Phoenix, AZ 85044-6094

Mailing address

4530 E Ray Rd
Suite 150
Phoenix, AZ 85044-6094
Phone (480) 503-3344

Other names 1

  • Arizona Back Institute Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Arizona Back Institue2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700910270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E RAY RD",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446094",
            "telephone_number": "480-503-3344",
            "fax_number": "480-763-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E RAY RD",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446094",
            "telephone_number": "480-503-3344",
            "fax_number": "480-763-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA MEDICAL SPINE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-503-3344",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AZ",
            "license": "20012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Back Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, 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.