Surgery Specialists at the River, PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4512 Issued in AZ

Legal business name

SURGERY SPECIALISTS AT THE RIVER, PLLC

Practice address

5287 S Highway 95 Ste D
Fort Mohave, AZ 86426-9220

Phone

(928) 542-4727

Fax

(866) 504-1133

NPI assigned

Feb 8, 2007

Last updated

Jun 13, 2012By 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

Dr. Ronald D Weissenberg, D.O.

Title

General Surgeon

Phone

(928) 542-4727

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1992846414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5287 S HIGHWAY 95 STE D",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269220",
            "telephone_number": "928-542-4727",
            "fax_number": "866-504-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5287 S HIGHWAY 95 STE D",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269220",
            "telephone_number": "928-542-4727",
            "fax_number": "866-504-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY SPECIALISTS AT THE RIVER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "WEISSENBERG",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "GENERAL SURGEON",
        "authorized_official_telephone_number": "928-542-4727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "AZ",
            "license": "4512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "491439",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.