JCL Gastroenterology, LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

JCL GASTROENTEROLOGY, LLC

Practice address

20745 N Scottsdale Rd Ste 120
Scottsdale, AZ 85255-6453

Phone

(480) 882-7510

Fax

(480) 946-3711

NPI assigned

Dec 3, 2019

Organization subpart

No

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

Authorized official

Name

Savas Petrides

Title

SVP

Phone

(480) 696-4020

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575331200000",
    "number": "1811534480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274172",
            "telephone_number": "480-587-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20745 N SCOTTSDALE RD STE 120",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852556453",
            "telephone_number": "480-882-7510",
            "fax_number": "480-946-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JCL GASTROENTEROLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2019-12-03",
        "status": "A",
        "authorized_official_last_name": "PETRIDES",
        "authorized_official_first_name": "SAVAS",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "480-696-4020"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Gastroenterology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.