EAST VALLEY SPINE AND SPORTS MEDICINE CENTER, PLC


Address: 4858 E Baseline Rd, Suite 107, Mesa, AZ 85206-4638
Phone: 4808076500

EAST VALLEY SPINE AND SPORTS MEDICINE CENTER, PLC (NPI# 1659402998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659402998
Entity Type Organization
Organization Name EAST VALLEY SPINE AND SPORTS MEDICINE CENTER, PLC
Other Organization Name TUTANKHAMEN PAPPOE MD PLC
Practice Address 4858 E Baseline Rd
Suite 107
Mesa
AZ 85206-4638
Mailing Address 4858 E Baseline Rd Ste 107
Mesa
AZ 85206-4638
Practice Telephone 4808076500
Practice Fax Number 8668357591
Mailing Telephone 4808076500
Mailing Fax Number 8668357591
Enumeration Date 2007-03-08
Last Update Date 2015-06-16
Authorized Official Name DR. TUTANKHAMEN ALLOTEY PAPPOE (OWNER AND PHYSICIAN)
Authorized Official Telephone 4808076500
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2081S0010X Physical Medicine & Rehabilitation
Specialization: Sports Medicine
33084 AZ Allopathic & Osteopathic Physicians
Y 2081P2900X Physical Medicine & Rehabilitation
Specialization: Pain Medicine
33084 AZ Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AZ 873671 05

Other Provider/Organization Names

Other Name Type Code
Tutankhamen Pappoe MD PLC Former Legal Business Name - Organization

Office Location

Street Address 4858 E BASELINE RD
SUITE 107
City MESA
State AZ
Zip Code 85206-4638

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932412533 Medical Flight Services, LLC Ambulance 4858 E Baseline Rd, Suite 101, Mesa, AZ 85206-4638 2010-07-23
1750582730 Ryan S Fauble Md Pllc Internal Medicine 4858 E Baseline Rd, Suite #f107, Mesa, AZ 85206-4638 2007-05-29
1740491737 Steven C. Kaiser Md Pllc Internal Medicine 4858 E Baseline Rd, Suite #f107, Mesa, AZ 85206-4638 2007-05-24

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1720693062 Inner Balance Counseling LLC Counselor 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 2020-09-14
1356978969 Choices 4 Change Counseling and Coaching LLC Social Worker 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 2020-03-24
1023651288 Jason Mcclure Hearing Instrument Specialist 5540 E Broadway Rd., Mesa, AZ 85206 2019-10-21
1255995361 Vhs of Phoenix Inc General Acute Care Hospital 5750 E. Baseline Rd., Mesa, AZ 85206 2019-04-24
1932682184 Adam Fishel Frose Psychologist 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 2018-09-13
1376024737 Robyn Kathleen Hall Psychologist 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 2018-08-23
1790264984 Perspective Health, LLC Clinic/Center 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 2018-08-09
1033605159 Rebecca Ann Maro Nurse Practitioner 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 2018-07-02
1982195624 Spark Performance and Physiotherapy Clinic/Center 6056 East Basline Road, Suite 147, Mesa, AZ 85206 2018-05-29
1336645993 Ashley Wright Audiologist-Hearing Aid Fitter 1423 S Higley Rd Ste 119, Mesa, AZ 85206 2018-04-03
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Taxonomy Information

Taxonomy Code 2081P2900X
Grouping Allopathic & Osteopathic Physicians
Classification Physical Medicine & Rehabilitation
Specialization Pain Medicine

Taxonomy Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134785967 Dylan Irish Physical Medicine & Rehabilitation 5233 E Southern Ave Ste 104, Mesa, AZ 85206-3628 2019-05-16
1437437605 M S C Holding Group LLC Physical Medicine & Rehabilitation 1640 S Stapley Dr, Suite 245, Mesa, AZ 85204-6667 2011-07-22
1568643047 Premier Physician's Group, Pllc Physical Medicine & Rehabilitation 4540 E Baseline Rd Ste 105, Mesa, AZ 85206-4616 2007-11-26
1588610646 Joseph R Gottesman, LLC Physical Medicine & Rehabilitation 2023 W Guadalupe Rd, Ste 11-181, Mesa, AZ 85202-7371 2006-05-26
1053939066 Ace Medical Group LLC Physical Medicine & Rehabilitation 5233 E Southern Ave Ste 104, Mesa, AZ 85206-3628 2020-07-07
1700404712 Apple Medical Group LLC Physical Medicine & Rehabilitation 5233 E Southern Ave Ste 103, Mesa, AZ 85206-3628 2020-07-07
1548804800 Mesa Regen Group, LLC Physical Medicine & Rehabilitation 5233 E Southern Ave Ste 103, Mesa, AZ 85206-3628 2019-10-30
1699122960 Oasis Pm&r Services, Pllc Physical Medicine & Rehabilitation 5652 E Baseline Rd, Mesa, AZ 85206-4713 2016-05-17
1730505017 Pioneer Sports and Spine Pllc Physical Medicine & Rehabilitation 5652 E Baseline Rd, Mesa, AZ 85206-4713 2014-03-11
1740601962 Calgary Medical LLC Physical Medicine & Rehabilitation 4540 E Baseline Rd, Suite 105, Mesa, AZ 85206-4613 2013-12-16
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Competitor

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City MESA
Zip Code 85206

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Dataset Information

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.

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