NPIMap

Organization Active NPI

Arizona Iom LLC

  • Electroneurodiagnostic Specialist/Technologist
  • Gilbert, AZ
National Provider Identifier
1831577139
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
Legal business name
ARIZONA IOM LLC
Practice address
2301 West Sanoque Court
Gilbert, AZ 85298
Phone
(720) 503-5711
NPI assigned
May 7, 2015
Last updated
Oct 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Authorized official

Name
Matthew L. Fordyce
Title
Managing Partner
Phone
(619) 458-6306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X Primary

Addresses

Primary practice location

2301 West Sanoque Court
Gilbert, AZ 85298

Mailing address

2907 Shelter Island Dr.
Suite 105-612
San Diego, CA 92106-2743
Phone (602) 734-1405

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539129600000",
    "number": "1831577139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 SHELTER ISLAND DR.",
            "address_2": "SUITE 105-612",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921062743",
            "telephone_number": "602-734-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 WEST SANOQUE COURT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85298",
            "telephone_number": "720-503-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA IOM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2018-10-10",
        "status": "A",
        "authorized_official_last_name": "FORDYCE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "619-458-6306"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; 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.