Desert Ridge Pain Facility

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DESERT RIDGE PAIN FACILITY

Practice address

21001 N Tatum Blvd Ste 78-1640
Phoenix, AZ 85050-5244

Phone

(480) 773-7662

NPI assigned

Apr 6, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Mike Cormier, DC

Title

Managing Partner

Phone

(480) 773-7662

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1760061758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 N MILLER RD STE 240",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD STE 78-1640",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850505244",
            "telephone_number": "480-773-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT RIDGE PAIN FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "CORMIER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "480-773-7662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Ridge Medical Group
• Desert Ridge Medical Group Anesthesia LLC
• Desert Ridge Medical LLC
• Desert Ridge Oral,Facial & Implant Surgery, PLLC
• Desert Ridge Outpatient Surgery LLC
• Desert Ridge Pediatric Dentistry
• Desert Ridge Prosthodontics
• Desert Ridge Surgical Specialists, LLC
• Desert Ridge Urgent Care LLC
• Desert Run Multispecialty PLC

• Ambulatory Surgical Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; 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.