NPIMap

Organization Active NPI

Southwest Endovascular Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
National Provider Identifier
1760021802
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SOUTHWEST ENDOVASCULAR CENTER, LLC
Practice address
7529 E Broadway Rd
Mesa, AZ 85208
Phone
(480) 945-4343
Fax
(480) 945-4350
NPI assigned
Jan 6, 2020
Last updated
Jan 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Authorized official

Name
Nettie Castillo
Title
Credentialing Specialist
Phone
(480) 542-4714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

7529 E Broadway Rd
Mesa, AZ 85208

Mailing address

140 S Power Rd Ste 102
Mesa, AZ 85206-5297
Phone (480) 542-4714

National Provider Directory

National Provider Directory

Locations

140 S Power Rd
Ste 102
Mesa, AZ 85206
Phone (602) 966-2081

7529 E Broadway Rd
Mesa, AZ 85208

7529 E Broadway Rd
Ste 101
Mesa, AZ 85208

Practitioners & affiliated clinicians

Practitioners 10

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": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1760021802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S POWER RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065297",
            "telephone_number": "480-542-4714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7529 E BROADWAY RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85208",
            "telephone_number": "480-945-4343",
            "fax_number": "480-945-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST ENDOVASCULAR CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "NETTIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "480-542-4714"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.