SPORTSMEDICINE OUTREACH SPECIALIST (NPI# 1053898833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053898833 |
| Entity Type | Organization |
| Organization Name | SPORTSMEDICINE OUTREACH SPECIALIST |
| Practice Address |
13247 N 80th Pl Scottsdale AZ 85260-4903 |
| Mailing Address |
Po Box 5238 Scottsdale AZ 85261-5238 |
| Practice Telephone | 6026899588 |
| Mailing Telephone | 6026899588 |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |
| Authorized Official Name | MR. MATTHEW DEAN OVERLIN (PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 6026899588 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3233 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
13247 N 80TH PL |
| City | SCOTTSDALE |
| State | AZ |
| Zip Code | 85260-4903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153377 | Karen Lee Williams | Counselor | 7655 Eest Redfield Rd, Suite 4, Scottsdale, AZ 85260 | 2020-10-29 |
| 1477188001 | Dr. Lynne Remson, Stuttering Specialist, LLC | Clinic/Center | 7950 E. Acoma Dr., Ste 201, Scottsdale, AZ 85260 | 2020-03-04 |
| 1861049967 | Aca Wellness Institute | Registered Nurse | 10752 N. 89th Pl, 8, Ste 203, Scottsdale, AZ 85260 | 2019-08-22 |
| 1811542814 | Haven Home Physicians LLC | Internal Medicine | 15551 N Greenway-hayden Loop, Suite 155, Scottsdale, AZ 85260 | 2019-08-06 |
| 1700431079 | Corey Allen Niles | Physical Therapist | 16413 N 91st Street #c145, Scottsdale, AZ 85260 | 2019-08-05 |
| 1578126470 | Scottsdale Pediatric Dental Associates Inc | Dentist | 9280 E Raintree, Suite 108, Scottsdale, AZ 85260 | 2019-04-16 |
| 1548747645 | Oliver Canizales Renteria | Behavior Technician | 8310 East Cactus Road, Suite # 510, Scottsdale, AZ 85260 | 2018-07-23 |
| 1518454792 | Silent Night Sleep Center Lllp | Durable Medical Equipment & Medical Supplies | 9070 E Desert Cove Ave Ste 105, Scottsdale, AZ 85260 | 2018-04-13 |
| 1669976726 | Steincare Mobile Outpatient, LLC | Occupational Therapist | 9555 E. Raintree Drive, #2057, Scottsdale, AZ 85260 | 2018-03-22 |
| 1437658416 | Megan Anne Deffenbaugh | Behavior Technician | 8130 E Cactus Rd Suite 150, Scottsdale, AZ 85260 | 2018-02-06 |
| Find all providers in zip 85260 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831582204 | Kelly Jackson | Physician Assistant | 9345 E Voltaire Ave, Scottsdale, AZ 85260-7432 | 2015-03-10 |
| 1336577188 | Elizabeth L Vito Pllc | Physician Assistant | 10055 E Mountainview Lake Dr Unit 1012, Scottsdale, AZ 85258-5268 | 2013-10-14 |
| 1053667600 | Neurological Surgical Assisting, LLC | Physician Assistant | 5204 E Wallace Ave, Scottsdale, AZ 85254 | 2012-08-01 |
| 1215231196 | Megan M Conover | Physician Assistant | 8841 E Bell Rd Ste 201, Scottsdale, AZ 85260 | 2011-01-06 |
| 1144364795 | Emprise Surgical Associate Pllc | Physician Assistant | 7846 E Vista Bonita Dr, Scottsdale, AZ 85255-4123 | 2007-02-16 |
| 1568539716 | Scott C Smith | Physician Assistant | 11221 N 89th Way, Scottsdale, AZ 85260-6180 | 2006-11-30 |
| 1063448389 | Kavita Saggar | Physician Assistant | 8888 E Raintree Dr, Suite 170, Scottsdale, AZ 85260-3951 | 2006-06-26 |
| 1386692572 | Steven M Gabaldon | Physician Assistant | 10213 N 92nd St, Suite 101, Scottsdale, AZ 85258-4561 | 2006-05-04 |
| 1558349134 | Elizabeth L Vito | Physician Assistant | 1776 N Scottsdale Rd Unit 368, Scottsdale, AZ 85252-3616 | 2006-01-04 |
| 1255964375 | Hania Alexandra Alexander | Physician Assistant | 7960 E Thompson Peak Pkwy Ste 104, Scottsdale, AZ 85255-7406 | 2020-02-17 |
| Find all providers in SCOTTSDALE | ||||
| City | SCOTTSDALE |
| Zip Code | 85260 |
Please comment or provide details below to improve the information on SPORTSMEDICINE OUTREACH SPECIALIST.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.