Organization Active NPI

True Diabetes Neuropathy & Wound Solutions Az LLC

  • General Practice Physician
  • Show Low, AZ
National Provider Identifier
1912699240
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
TRUE DIABETES NEUROPATHY & WOUND SOLUTIONS AZ LLC
Practice address
5171 S Cub Lake Rd Ste C330
Show Low, AZ 85901-7997
Phone
(928) 243-0348
Fax
(928) 328-1288
NPI assigned
May 24, 2023
Last updated
Feb 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Patrick Smith
Title
Chief Information Officer
Phone
(480) 740-1910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

5171 S Cub Lake Rd Ste C330
Show Low, AZ 85901-7997

Mailing address

5171 S Cub Lake Rd Ste C330
Show Low, AZ 85901-7997
Phone (928) 243-0348

Other practice location 1

4828 S Val Vista Dr
Gilbert, AZ 85298-7323
Phone (480) 550-8767

Other identifiers 2

IdentifierTypeStateIssuer
1366183212OtherAZNPI
1598314247OtherAZNPI

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": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1912699240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5171 S CUB LAKE RD STE C330",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017997",
            "telephone_number": "928-243-0348",
            "fax_number": "480-977-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 S CUB LAKE RD STE C330",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017997",
            "telephone_number": "928-243-0348",
            "fax_number": "928-328-1288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4828 S Val Vista Dr",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852987323",
            "country_code": "US",
            "telephone_number": "480-550-8767",
            "fax_number": "480-977-1138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRUE DIABETES NEUROPATHY & WOUND SOLUTIONS AZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CHIEF INFORMATION OFFICER",
        "authorized_official_telephone_number": "480-740-1910"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1366183212",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1598314247",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.