Surprise Medical Group LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SURPRISE MEDICAL GROUP LLC

Practice address

13733 N. Prasada Parkway Suite 100
Surprise, AZ 85388

Phone

(480) 497-2900

NPI assigned

Aug 20, 2021

Organization subpart

No

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

Authorized official

Name

Greg Vogel

Title

Ceo

Phone

(480) 497-2900

Specialties & licenses 5

Addresses

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

{
    "created_epoch": "1629417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1982370839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "754 S VAL VISTA DR STE 105",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13733 N. PRASADA PARKWAY SUITE 100",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85388",
            "telephone_number": "480-497-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURPRISE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-20",
        "last_updated": "2021-08-20",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "VOGEL",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-497-2900"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Surprise, AZ
• Providers in Surprise, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.