Desert Rehab Provider, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

DESERT REHAB PROVIDER, LLC

Practice address

1675 E Villa St
Phoenix, AZ 85006-4435

Phone

(480) 801-6700

NPI assigned

Mar 8, 2023

Organization subpart

No

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

Authorized official

Name

Dr. David Jung, MDNPI 1255751749

Title

Owner

Phone

(989) 798-3087

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Lee Jung, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
  • NPI 1255751749
  NPD Authorized official

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

{
    "created_epoch": "1678233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1942900980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16772 W BELL RD STE 110-619",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853749702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 E VILLA ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850064435",
            "telephone_number": "480-801-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT REHAB PROVIDER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-798-3087",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Desert Ridge Facility LLC
• Desert Ridge Gastroenterology
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• Physical Medicine & Rehabilitation Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physical Medicine & Rehabilitation Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; 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.