SOUTHWEST SPORTS AND SPINE (NPI# 1346636578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346636578 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST SPORTS AND SPINE |
| Practice Address |
400 W Camino Casa Verde Ste 100 Green Valley AZ 85614-3569 |
| Mailing Address |
5860 N La Cholla Blvd Ste 150 Tucson AZ 85741-3562 |
| Practice Telephone | 5203950512 |
| Practice Fax Number | 5205054108 |
| Mailing Telephone | 5203950512 |
| Mailing Fax Number | 5205054108 |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |
| Authorized Official Name | EUGENE JOHNSON (MD) |
| Authorized Official Telephone | 5203950512 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 34986 | AZ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 347495 | 05 |
| Street Address |
400 W CAMINO CASA VERDE STE 100 |
| City | GREEN VALLEY |
| State | AZ |
| Zip Code | 85614-3569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912317579 | Tia Heng | Internal Medicine | 400 W Camino Casa Verde Ste 100, Green Valley, AZ 85614-3569 | 2014-05-05 |
| 1629443502 | Carol Avila | Nurse Practitioner | 400 W Camino Casa Verde Ste 100, Green Valley, AZ 85614-3569 | 2015-12-03 |
| 1528455391 | Chioma Ogala | Internal Medicine | 400 W Camino Casa Verde Ste 100, Green Valley, AZ 85614-3569 | 2015-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033773791 | Medavail Pharmacy Inc. | Pharmacy | 5750 S Turquoise Canyon Dr, Green Valley, AZ 85614 | 2019-04-29 |
| 1447742788 | Shanae Murphy | Nurse Practitioner | 1260 S Campbell Ave Unit 2, Green Valley, AZ 85614 | 2018-06-02 |
| 1487173332 | Chirocade, Inc. | Chiropractor | 380 W Vista Hermosa Dr., Ste # 100, Green Valley, AZ 85614 | 2017-09-12 |
| 1922536150 | Melinda Suzanne Prado | Dental Hygienist | 1260 S Campbell Rd Bldg 2, Green Valley, AZ 85614 | 2017-06-01 |
| 1295274579 | Nitika Sharma | Dentist | Dental Village, 140 W Duval Mine Rd, Green Valley, AZ 85614 | 2017-02-19 |
| 1508212960 | Amy Priftakis | Nurse Practitioner | 4455 N I-19 Frontage Rd., Green Valley, AZ 85614 | 2016-05-04 |
| 1730547134 | Cope Community Services, Inc. | Psychiatry & Neurology | 1660 W Commerce Point Pl, Green Valley, AZ 85614 | 2016-02-01 |
| 1548656457 | Southern Arizona Sleep Solutions | Durable Medical Equipment & Medical Supplies | 261 W Duval Road, Green Valley, AZ 85614 | 2015-04-08 |
| 1770978041 | Empower Green Valley Pllc | Emergency Medicine | 4455 S. I-19 Frontage Road, Greenvalley, AZ 85614 | 2015-04-02 |
| 1295125078 | Gv Hospital Management LLC | General Acute Care Hospital | 4455 South I-19 Frontage Road, Green Valley, AZ 85614 | 2015-01-30 |
| Find all providers in zip 85614 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447403670 | Dawn Marie Degara | Specialist | 300 W Via Alamos #715 St, Green Valley, AZ 85614 | 2008-10-31 |
| 1528199239 | Anthony Alexander Allen | Specialist | 230 W Continental Rd Ste 416, Green Valley, AZ 85622-3591 | 2007-03-07 |
| 1730165671 | Martin L Brown | Specialist | 400 W. Camino Casa Verde, Green Valley, AZ 85614 | 2005-12-22 |
| 1043204894 | Alex R Verhoogen | Specialist | 4485 S I-19 Frontage Rd, Ste 100, Green Valley, AZ 85614 | 2005-09-08 |
| 1942531702 | Simply Feet LLC | Specialist | 75 W Calle De Las Tiendas, Suite 133b, Green Valley, AZ 85614-4235 | 2010-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942810833 | Modern Sports Medicine LLC | Specialist | 6242 E Arbor Ave Unit 1, Mesa, AZ 85206-1309 | 2020-08-05 |
| 1518576123 | Multi Specialty Physicians Group Inc | Specialist | 8428 E Shea Blvd Ste 101, Scottsdale, AZ 85260-6663 | 2020-07-29 |
| 1902420698 | Doug S Clouse Md Plc | Specialist | 3636 N Stockton Hill Rd Ste 3, Kingman, AZ 86409-0514 | 2020-05-29 |
| 1518580869 | Zegarra Hospital and Nursing Home Services Pllc | Specialist | 2182 Hway 95, Bullhead City, AZ 86442-6044 | 2020-05-21 |
| 1154942829 | Fresh Start Bone and Joint Institue | Specialist | 485 S Watson Rd Ste 103-438, Buckeye, AZ 85326-3452 | 2020-05-04 |
| 1902462179 | Physician Group of Arizona Inc | Specialist | 4801 E Washington St Ste 200, Phoenix, AZ 85034-2019 | 2019-05-14 |
| 1447814751 | Carmen Tasse | Specialist | 3260 N Hayden Rd Ste 110, Scottsdale, AZ 85251-6650 | 2019-04-23 |
| 1790246924 | Mark A Meyers | Specialist | 715 S Beeline Hwy Ste A, Payson, AZ 85541-5344 | 2019-03-29 |
| 1386113538 | Wound Care Associates LLC | Specialist | 2600 E Southern Ave Ste F2, Tempe, AZ 85282-7626 | 2018-11-16 |
| 1366920910 | Haleys Designer Wigs | Specialist | 6017 E Mckellips Rd Ste 109, Mesa, AZ 85215-2824 | 2018-08-04 |
| Find all providers with the same taxonomy | ||||
| City | GREEN VALLEY |
| Zip Code | 85614 |
Please comment or provide details below to improve the information on SOUTHWEST SPORTS AND SPINE.
| 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.