The Phoenix Oversight and Consulting, LLC.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

THE PHOENIX OVERSIGHT AND CONSULTING, LLC.

Practice address

7746 Rannells Ave
Saint Louis, MO 63143-1823

Phone

(636) 226-4159

NPI assigned

Oct 23, 2018

Last updated

Oct 23, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan Kidd, CNIMNPI 1295948560

Title

Owner/Chief Operating Officer

Phone

(217) 821-0759

Specialties & licenses 1

Addresses

Practitioners 3

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.

• Jonathan J Kidd, CNIM

  • Electroneurodiagnostic Specialist/Technologist
  • Maplewood, MO
  • NPI 1295948560
  NPD Authorized official
• Anthony Clark Dunning, B.S.

  • Electroneurodiagnostic Specialist/Technologist
  • Plymouth, MI
  • NPI 1871132548
  NPD (past)
• Maria Alexandra Santos

  • Electroneurodiagnostic Specialist/Technologist
  • Plymouth, MI
  • NPI 1295440766
  NPD (past)

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1922574391",
    "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": "7746 RANNELLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631431823",
            "telephone_number": "636-226-4159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1737 W Powers Ave",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "CO",
            "postal_code": "801201209",
            "country_code": "US",
            "telephone_number": "217-821-0759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE PHOENIX OVERSIGHT AND CONSULTING, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "KIDD",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER/CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "217-821-0759",
        "authorized_official_credential": "CNIM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.