Active NPI
Integrated Matrix Anesthesia Services LLC
- Anesthesiology Physician
- Scottsdale, AZ
National Provider Identifier
1881110179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- INTEGRATED MATRIX ANESTHESIA SERVICES LLC
- Practice address
- 20401 N 73Rd St Ste 155
Scottsdale, AZ 85255-4149 - Phone
- (602) 328-0382
- NPI assigned
- Aug 17, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shane L Martin, MD
- Title
- Manager
- Phone
- (602) 328-0382
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
20401 N 73Rd St Ste 155
Scottsdale, AZ 85255-4149
Mailing address
2801 Centerville Road
PMB 642
Wilmington, DE 19808
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1502928000000",
"number": "1881110179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 CENTERVILLE ROAD",
"address_2": "PMB 642",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "19808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20401 N 73RD ST STE 155",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852554149",
"telephone_number": "602-328-0382"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTEGRATED MATRIX ANESTHESIA SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-08-17",
"last_updated": "2017-08-17",
"status": "A",
"authorized_official_last_name": "MARTIN",
"authorized_official_first_name": "SHANE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "602-328-0382",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.