NPIMap

Organization Active NPI

Yuma Az Endoscopy ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Yuma, AZ
National Provider Identifier
1972578367
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
OSC 3889 Issued in AZ
Legal business name
YUMA AZ ENDOSCOPY ASC LLC
Practice address
1030 W 24TH St
Suite 1
Yuma, AZ 85364-8384
Phone
(928) 343-1717
Fax
(928) 343-1011
NPI assigned
Feb 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Mr. Phillip A Clendenin
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X OSC 3889 AZ Primary

Addresses

Primary practice location

1030 W 24TH St
Suite 1
Yuma, AZ 85364-8384

Mailing address

1030 W 24TH St
Suite 1
Yuma, AZ 85364-8384
Phone (928) 343-1717

Other identifiers 1

IdentifierTypeStateIssuer
116880MedicaidAZ

Other names 1

  • Endoscopy Center of Yuma Doing business as

National Provider Directory

National Provider Directory

Locations

1030 W 24th St
Ste 1
Yuma, AZ 85364
Phone (928) 343-1717

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1972578367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 W 24TH ST",
            "address_2": "SUITE 1",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648384",
            "telephone_number": "928-343-1717",
            "fax_number": "928-343-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 W 24TH ST",
            "address_2": "SUITE 1",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853648384",
            "telephone_number": "928-343-1717",
            "fax_number": "928-343-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YUMA AZ ENDOSCOPY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-21",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC 3889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116880",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endoscopy Center of Yuma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.