Paincare of Arizona, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

OTC4249 Issued in AZ

Legal business name

PAINCARE OF ARIZONA, LLC

Practice address

10815 W McDowell Rd
Suite 304
Avondale, AZ 85392-5007

Phone

(623) 433-0199

Fax

(623) 433-0198

NPI assigned

Oct 2, 2007

Organization subpart

No

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

Authorized official

Name

Sky Moore

Title

Owner

Phone

(602) 332-2338

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1861689986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10815 W MCDOWELL RD",
            "address_2": "SUITE 304",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925007",
            "telephone_number": "623-433-0199",
            "fax_number": "623-433-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10815 W MCDOWELL RD",
            "address_2": "SUITE 304",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925007",
            "telephone_number": "623-433-0199",
            "fax_number": "623-433-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAINCARE OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SKY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-332-2338"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AZ",
            "license": "OTC4249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ciana Pacheco
• Krystyna Pagel
• Jennifer Lynn Pahl, BS SLP
• Paincare Health Institute LLC
• Paincare Health Institute LLC
• Melissa Marie Paine, MS, BCBA, LBA
• Palm Valley Family Dentistry Inc
• Palm Valley Women'S Care
• Ezekiel George Palmani
• Riley Palmer III

• Medical Specialty Clinic/Center in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Medical Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.