Scottsdale Professional LLC

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Legal business name

SCOTTSDALE PROFESSIONAL LLC

Practice address

18521 E Queen Creek Rd
Ste 105-161
Queen Creek, AZ 85142-5866

Phone

(720) 503-5711

Fax

(602) 926-8841

NPI assigned

Mar 29, 2017

Organization subpart

No

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

Authorized official

Name

Kathy Reed

Title

Manager

Phone

(720) 503-5711

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ji Yong Kim, CNIM, R. EP. T.

  • Electroneurodiagnostic Specialist/Technologist
  • Gilbert, AZ
  • NPI 1952766602
  NPD (past)

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1790217792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "MILAM",
            "state": "TX",
            "postal_code": "759590096",
            "telephone_number": "225-588-4845",
            "fax_number": "602-926-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18521 E QUEEN CREEK RD",
            "address_2": "STE 105-161",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425866",
            "telephone_number": "720-503-5711",
            "fax_number": "602-926-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "720-503-5711"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmine Schellenberg, COTA/L
• Marcella L Schrift
• Lorale Schultz, CSFA
• McKenzee Schultz
• Scott Peterson DMD Ms PLLC
• Hannah Scovil
• Secora LLC
• Secure Ride LLC
• Select Med LLC
• Select Med LLC

• Electroneurodiagnostic Specialist/Technologist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Electroneurodiagnostic Specialist/Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.