DAVID IANNICCA (NPI# 1245455666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245455666 |
| Entity Type | Individual |
| Full Name | DAVID IANNICCA |
| Credential | ATC |
| Practice Address |
15946 N Bullard Ave Surprise AZ 85374-8844 |
| Mailing Address |
920 Center Rd Eastlake OH 44095-2332 |
| Practice Telephone | 8162772954 |
| Mailing Telephone | 4402230569 |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
0126000756 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
15946 N BULLARD AVE |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85374-8844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306333182 | Gavin Grosh | Physical Medicine & Rehabilitation | 15946 N Bullard Ave, Surprise, AZ 85374-8844 | 2018-04-17 |
| 1487941035 | Justin J Hahn | Physical Therapist | 15946 N Bullard Ave, Surprise, AZ 85374-8844 | 2011-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225648801 | Jennilyn Joy Puhawan Cave | Emergency Medicine | 14440 W Tierra Buena Ln, Surprise, AZ 85374 | 2020-08-07 |
| 1912538497 | Dental Depot of Surprise, Pllc | Clinic/Center | 13828 W. Greenway Rd., Surprise, AZ 85374 | 2020-02-03 |
| 1447898622 | Vhs of Arrowhead, Inc. | General Acute Care Hospital | 16815 W. Bell Rd, Surprise, AZ 85374 | 2019-12-18 |
| 1073155834 | Regency Ambulatory Surgery Center One, LLC | Clinic/Center | 14753 W Mountain View Blvd, Surprise, AZ 85374 | 2019-10-14 |
| 1164064929 | Advanced Ambulatory Surgery Center One, LLC | Clinic/Center | 14753 W. Mountain View Blvd., Surprise, AZ 85374 | 2019-10-14 |
| 1275005308 | Filsan Ali | Nurse Practitioner | 14780 W Mountain View Blvd #109, Surprise, Az 85374, Surprise, AZ 85374 | 2018-12-31 |
| 1427528686 | Anna L Bell | Nurse Practitioner | 14811 W Bell Rd Ste 100, Surprise, AZ 85374 | 2018-11-30 |
| 1649755893 | Surprise Behavioral Hospital Lp | Psychiatric Hospital | 16561 North Parkview Place, Surprise, AZ 85374 | 2018-10-03 |
| 1336621259 | Chaparral Winds LLC | Assisted Living Facility | 16623 N West Point Parkway, Surprise, AZ 85374 | 2018-09-06 |
| 1104310648 | Austin Daniel Lau | Dentist | 17018 W Bell Rd, Surprise, AZ 85374 | 2018-06-19 |
| Find all providers in zip 85374 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306333182 | Gavin Grosh | Physical Medicine & Rehabilitation | 15946 N Bullard Ave, Surprise, AZ 85374-8844 | 2018-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233785 | Tara Anne Condon | Physical Medicine & Rehabilitation | 3300 W Camelback Rd Bldg 12, Phoenix, AZ 85017-3030 | 2019-06-12 |
| 1528556495 | Stone Med, LLC | Physical Medicine & Rehabilitation | 77 S Dobson Rd., Phoenix, AZ 85224 | 2018-04-26 |
| 1801390885 | Melissa Abellanida | Physical Medicine & Rehabilitation | 9127 W Thunderbird Rd Ste 101, Peoria, AZ 85381-4887 | 2018-03-22 |
| 1386173748 | Aliesje Nichole Thrower | Physical Medicine & Rehabilitation | 8465 E Hodgman Pl, Tucson, AZ 85747 | 2017-06-08 |
| 1194167858 | Rejuv Medical Southwest Corp | Physical Medicine & Rehabilitation | 7790 N Oracle Rd, Suite 150, Tucson, AZ 85704-6579 | 2013-07-23 |
| 1366622466 | Jonathan David Tait | Physical Medicine & Rehabilitation | 7790 N Oracle Rd Ste 150, Suite 150, Oro Valley, AZ 85704-6589 | 2007-11-06 |
| 1659402998 | East Valley Spine and Sports Medicine Center, Plc | Physical Medicine & Rehabilitation | 4858 E Baseline Rd, Suite 107, Mesa, AZ 85206-4638 | 2007-03-08 |
| 1821141250 | Sholom Gootzeit | Physical Medicine & Rehabilitation | 17233 N Holmes Blvd Ste 1640, 13761 W. Bell Road, Suite 203, Surprise, Az 85374, Phoenix, AZ 85053-2020 | 2007-01-19 |
| 1497728372 | Michael G. Crincoli | Physical Medicine & Rehabilitation | 1012 East Willetta Street, Phoenix, AZ 85006 | 2006-02-09 |
| 1457910416 | George Hackett | Physical Medicine & Rehabilitation | 3300 W Camelback Rd, Phoenix, AZ 85017-1097 | 2019-06-12 |
| Find all providers with the same taxonomy | ||||
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| 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.