NPIMap

Organization Active NPI

Arizona Heart Institute SCW

  • Cardiovascular Disease Physician
  • Surprise, AZ
National Provider Identifier
1881895498
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ARIZONA HEART INSTITUTE SCW
Practice address
13967 W Grand Ave
Suite 100
Surprise, AZ 85374-3548
Phone
(623) 584-0052
Fax
(623) 584-3706
NPI assigned
May 30, 2007
Last updated
Oct 22, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA HEART INSTITUTE LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Authorized official

Name
Edward Diethrich, M.D.
Title
Medical Director
Phone
(602) 266-2200

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X NU
Family Nurse Practitioner 363LF0000X NU
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU Primary
Interventional Cardiology Physician 207RI0011X NU
Nuclear Cardiology Physician 207UN0901X NU

Addresses

Primary practice location

13967 W Grand Ave
Suite 100
Surprise, AZ 85374-3548

Mailing address

PO Box 61773
Phoenix, AZ 85082-1773
Phone (602) 682-6727

National Provider Directory

National Provider Directory
Tax ID family
Ariz Heart Inst LTD13 organizations share this tax ID, including this one
Part of
Ariz Heart Inst LTD

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

13967 W Grand Ave
Ste 100
Surprise, AZ 85374
Phone (623) 474-3952

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1881895498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61773",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850821773",
            "telephone_number": "602-682-6727",
            "fax_number": "602-240-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13967 W GRAND AVE",
            "address_2": "SUITE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743548",
            "telephone_number": "623-584-0052",
            "fax_number": "623-584-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA HEART INSTITUTE SCW",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA HEART INSTITUTE LTD",
        "enumeration_date": "2007-05-30",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "DIETHRICH",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "602-266-2200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.