NPIMap

Organization Active NPI

Phoenix Ionm, LLC.

  • Ambulatory Surgical Clinic/Center
  • East Wenatchee, WA
National Provider Identifier
1891357406
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PHOENIX IONM, LLC.
Practice address
11 Ohrazda LN
East Wenatchee, WA 98802-9335
Phone
(720) 435-5129
NPI assigned
Jul 3, 2019
Last updated
Jul 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Authorized official

Name
Mr. Jonathan Kidd, CNIMNPI 1295948560
Title
Chief Operating Officer
Phone
(217) 821-0759

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

11 Ohrazda LN
East Wenatchee, WA 98802-9335

Mailing address

5856 S Lowell Blvd # 32-403
Littleton, CO 80123-7915

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1891357406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5856 S LOWELL BLVD # 32-403",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801237915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 OHRAZDA LN",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988029335",
            "telephone_number": "720-435-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX IONM, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "KIDD",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "217-821-0759",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CNIM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Wenatchee, WA

Sources for this page

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