NPIMap

Organization Active NPI

Az Ortho & JNT Replace CNTR

  • Specialist
  • Tucson, AZ
National Provider Identifier
1700940202
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
30321 Issued in AZ
Legal business name
AZ ORTHO & JNT REPLACE CNTR
Practice address
630 N Alvernon Way Ste 161
Tucson, AZ 85711-1895
Phone
(520) 881-2600
Fax
(520) 881-2844
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Edward J Berghausen, MDNPI 1972589117
Title
President
Phone
(520) 881-2600

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 30321 AZ Primary

Addresses

Primary practice location

630 N Alvernon Way Ste 161
Tucson, AZ 85711-1895

Mailing address

1951 N Wilmot Rd
BLDG 2
Tucson, AZ 85712-8000
Phone (520) 881-2600

Other identifiers 1

IdentifierTypeStateIssuer
694902MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1700940202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 N WILMOT RD",
            "address_2": "BLDG 2",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857128000",
            "telephone_number": "520-881-2600",
            "fax_number": "520-881-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N ALVERNON WAY STE 161",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857111895",
            "telephone_number": "520-881-2600",
            "fax_number": "520-881-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ ORTHO & JNT REPLACE CNTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "BERGHAUSEN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-881-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "30321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "694902",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.