Desert Ridge Spine, Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC4914 Issued in AZ

Legal business name

DESERT RIDGE SPINE, INC

Practice address

3035 S Ellsworth Rd
Suite 109
Mesa, AZ 85212-2160

Phone

(480) 832-3318

Fax

(480) 621-7208

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Tom Ohara, D.C.

Title

President

Phone

(480) 832-3318

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1912035965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 S ELLSWORTH RD",
            "address_2": "SUITE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122160",
            "telephone_number": "480-832-3318",
            "fax_number": "480-621-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 S ELLSWORTH RD",
            "address_2": "SUITE 109",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122160",
            "telephone_number": "480-832-3318",
            "fax_number": "480-621-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT RIDGE SPINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "OHARA",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-832-3318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "DC4914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "AZ0236730",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desert Open MRI LLC
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• Desert Pediatric Hospitalists PLC
• Desert Ridge Hospice LLC
• Desert Rose OBGYN PC
• Desert Sky Endocrinology Associates PLC
• Desert Sounds Audiology & Hearing Aid Services, LLC
• Desert Sounds Audiology and Hearing (Desert Sounds Audiology)
• Desert Sounds Occupational Therapy

• Chiropractor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.