Organization Active NPI

Southwest Spine & Rehab PLLC

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1912331158
Registry record updated Oct 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8239 Issued in AZ
Legal business name
SOUTHWEST SPINE & REHAB PLLC
Practice address
2919 S Ellsworth Rd
Suite 102
Mesa, AZ 85212-2164
Phone
(480) 354-2008
Fax
(480) 907-1322
NPI assigned
Aug 23, 2013
Last updated
Oct 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2013

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

Authorized official

Name
Dr. Scott Alexander Taylor, D.C.NPI 1023381340
Title
Chiropractor/Owner
Phone
(480) 354-2008

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
Chiropractor 111N00000X 8239 AZ Primary

Addresses

Primary practice location

2919 S Ellsworth Rd
Suite 102
Mesa, AZ 85212-2164

Mailing address

2919 S Ellsworth Rd
Suite 102
Mesa, AZ 85212-2164
Phone (480) 354-2008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140714001431 AZ Part B Supplier - Clinic/Group Practice 9739304403 Receives reassigned benefits from 1 practitioner
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1377216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381708800000",
    "number": "1912331158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2919 S ELLSWORTH RD",
            "address_2": "SUITE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122164",
            "telephone_number": "480-354-2008",
            "fax_number": "480-907-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2919 S ELLSWORTH RD",
            "address_2": "SUITE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122164",
            "telephone_number": "480-354-2008",
            "fax_number": "480-907-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SPINE & REHAB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-10-14",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "480-354-2008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.