LAYNE C. SANDRIDGE (NPI# 1063689909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063689909 |
| Entity Type | Individual |
| Full Name | LAYNE C. SANDRIDGE |
| Credential | M.D. |
| Practice Address |
18700 N 64th Dr Ste 105a Glendale AZ 85308-7110 |
| Mailing Address |
19801 N 59th Ave Unit 11659 Glendale AZ 85318-5068 |
| Practice Telephone | 6236885075 |
| Practice Fax Number | 6236885075 |
| Mailing Telephone | 6236885075 |
| Mailing Fax Number | 6236885075 |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2019-01-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
40861 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 398159 | 05 | |
| AZ | MEDICARE | Z216660 | 01 |
| Street Address |
18700 N 64TH DR STE 105A |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85308-7110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497253546 | Layne Sandridge Md, Plc | Surgery | 18700 N 64th Dr Ste 105a, Glendale, AZ 85308-7110 | 2018-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972102572 | Inspire Wellness and Pelvic Health | Clinic/Center | 5940 W Union Hills Dr Ste D280, Glendale, AZ 85308 | 2020-10-23 |
| 1669081709 | Michelle Yoakim | Student in an Organized Health Care Education/Training Program | 19555 N 59th Avenuue, Glendale, AZ 85308 | 2020-07-24 |
| 1033742291 | Kaitlyn Marie Shannon | Dietitian, Registered | 20325 North 51st Avenue, Building 9, Suite 166, Glendale, AZ 85308 | 2020-02-17 |
| 1295377687 | Serenity Preserved Counseling Pllc | Counselor | 21448 N. 75th Avenue Ste G, Glendale, AZ 85308 | 2019-10-17 |
| 1013567023 | Caitlyn Heredia | Student in an Organized Health Care Education/Training Program | 18330 N 79th Avenue, Apartment 1070, Glendale, AZ 85308 | 2019-09-12 |
| 1770141061 | Sydney Dangelo | Student in an Organized Health Care Education/Training Program | 7454 W Denaro Dr, Glendale, AZ 85308 | 2019-05-31 |
| 1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
| 1831678341 | Ayat Mahdi Obeidi | Dentist | 19420 N 59th Ave Ste D400, Glendale, AZ 85308 | 2018-08-07 |
| 1720580038 | Lifeline Professional Counseling Services, Inc | Clinic/Center | 17235 N 75th Ave Suite F-100, Glendale, AZ 85308 | 2018-03-02 |
| 1003318585 | Danna Mavis Constance Moisii | Physician Assistant | 18301 N. 79th Ave #g190, Glendale, AZ 85308 | 2018-03-01 |
| Find all providers in zip 85308 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013531268 | Honorhealth Ambulatory | Surgery | 6220 W Bell Rd Ste 120, Glendale, AZ 85308-3896 | 2020-06-03 |
| 1447291893 | Sammy A Zakhary | Surgery | 6591 W Thunderbird Rd Ste D1, Glendale, AZ 85306-3720 | 2006-06-09 |
| 1568462943 | David Michael Smith | Surgery | 6320 W Union Hills Dr Ste 200, Glendale, AZ 85308-7239 | 2005-07-27 |
| 1912904509 | Cecil Cyrus Vaughn IIi | Surgery | 6677 W Thunderbird Rd, G-116, Glendale, AZ 85306-3709 | 2005-06-28 |
| 1497253546 | Layne Sandridge Md, Plc | Surgery | 18700 N 64th Dr Ste 105a, Glendale, AZ 85308-7110 | 2018-01-23 |
| 1164773560 | Kulbhushan K. Sharma Md, PC | Surgery | 5620 W Thunderbird Rd, Suite D-2, Glendale, AZ 85306-4636 | 2012-09-25 |
| 1437458239 | Brian Hoang | Surgery | 5757 West Thunderbird Road, Ste. E-456, Glendale, AZ 85306 | 2011-03-18 |
| 1780820217 | Hurwitz-roberts A Medical Corporation | Surgery | 1019 S Central Ave, Glendale, CA 91204-2210 | 2009-01-06 |
| 1538289152 | Southwest Vascular Institute Ltd | Surgery | 6677 W Thunderbird Rd, G 116, Glendale, AZ 85306-3709 | 2007-03-29 |
| 1760525752 | Foothill Surgical Specialists Medical Group | Surgery | 1560 E. Chevy Chase Dr., Suite 430, Glendale, CA 91206-4197 | 2007-02-15 |
| Find all providers in GLENDALE | ||||
Please comment or provide details below to improve the information on LAYNE C. SANDRIDGE.
| 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.