Cochise Surgical Care PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

23558 Issued in AZ

Legal business name

COCHISE SURGICAL CARE PLLC

Practice address

75 Colonia de Salud
Suite 100 C
Sierra Vista, AZ 85635-2485

Phone

(520) 452-0144

Fax

(520) 452-0075

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jody L Jenkins, MD

Title

Owner/Physician

Phone

(520) 452-0144

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1730109232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 COLONIA DE SALUD",
            "address_2": "STE C100",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352485",
            "telephone_number": "520-452-0144",
            "fax_number": "520-452-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 COLONIA DE SALUD",
            "address_2": "SUITE 100 C",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352485",
            "telephone_number": "520-452-0144",
            "fax_number": "520-452-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCHISE SURGICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "520-452-0144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "AZ",
            "license": "23558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "AZ0776250",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322222",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cochise Medical Oncology, LLC
• Cochise Oncology LLC
• Cochise Orthopaedic Surgeons PC
• Cochise Sleep Center LLC
• Cochise Sleep Center LLC
• Cochise Surgical Care, PLLC
• Cogent Healthcare of Arizona PC
• Richard Fred Cohen, D.P.M.
• Amanda L Colistro, PHARMD
• Tyler William Joe Collier, DO

• Surgery Physician in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.