SUN VALLEY SURGICAL PHYSICIAN ASSISTANT, LLC (NPI# 1669855193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669855193 |
| Entity Type | Organization |
| Organization Name | SUN VALLEY SURGICAL PHYSICIAN ASSISTANT, LLC |
| Practice Address |
9031 W Runion Dr Peoria AZ 85382-6472 |
| Practice Telephone | 6238107539 |
| Mailing Telephone | 6238107539 |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |
| Authorized Official Name | JENNIFER SPEER (PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 6238107539 |
| Authorized Official Credential | PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
3332 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9031 W RUNION DR |
| City | PEORIA |
| State | AZ |
| Zip Code | 85382-6472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205435146 | Arizona Ot Solutions LLC | Occupational Therapist | 7450 W. Karen Lee Lane, Peoria, AZ 85382 | 2020-10-21 |
| 1497380604 | Idream Psychiatry | Psychiatry & Neurology | 8194 West Deer Valley Rd, 106-516, Peoria, AZ 85382 | 2020-03-08 |
| 1770137648 | Stefan Cseh | Occupational Therapy Assistant | 8765 W Keiton Lane #116, Peona, AZ 85382 | 2019-07-30 |
| 1174177422 | Assyrian Cultural Foundation of Arizona | Homemaker | 9163 West Union Hills Drive, Suite 114 and 115, Peoria, AZ 85382 | 2019-07-25 |
| 1073072765 | Darby Shipman | Physical Therapist | 8685 W. Union Hills Drive, Peoria, AZ 85382 | 2019-03-13 |
| 1811483480 | Kimberly Ann Cochran | Nurse Practitioner | 8194 W Deer Valley Rd Ste 106-516, Peoria, AZ 85382 | 2018-07-07 |
| 1831693514 | Summa Health Care, PC | Family Medicine | 8877 W Union Hills Dr Ste 240, Peoria, AZ 85382 | 2018-03-19 |
| 1497258727 | Nkemdirim Obiora | Nurse Practitioner | 7853 West Lone Cactus Drive, Peoria, AZ 85382 | 2018-03-13 |
| 1851893721 | Alyssa Michelle Bauman | Registered Nurse | 20283 N Lake Pleasant Rd Ste 112, Peoria, AZ 85382 | 2018-03-06 |
| 1043767106 | Jason Mcaddley | Pharmacist | 9425 West Union Hills Drive, Peoria, AZ 85382 | 2016-09-07 |
| Find all providers in zip 85382 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487166690 | Erin M Carmean | Physician Assistant | 6000 N Allen Rd, Peoria, IL 61614-3294 | 2017-10-27 |
| 1427333087 | Colette K Hill | Physician Assistant | 1001 Main St Ste 300, Peoria, IL 61606-2036 | 2011-10-14 |
| 1184927709 | Mark D Lauffer | Physician Assistant | 6000 N Allen Rd, Peoria, IL 61614-3294 | 2010-12-21 |
| 1952476103 | Rebecca Barrick | Physician Assistant | 420 Ne Glen Oak Ave, Ste 301, Peoria, IL 61603-3105 | 2006-11-22 |
| 1891708491 | Gary Fisk | Physician Assistant | 5405 N Knoxville Ave, Peoria, IL 61614-5016 | 2006-08-14 |
| 1770507246 | Benjamin M Holman | Physician Assistant | 6000 N Allen Road, Peoria, IL 61614-3294 | 2006-07-27 |
| 1245268820 | Michael A Bumanglag | Physician Assistant | 9165 W Thunderbird Rd, Suite 200, Peoria, AZ 85381-4847 | 2006-06-30 |
| 1013972512 | Rob Wimmer | Physician Assistant | 7309 N Knoxville Ave, Peoria, IL 61614-2085 | 2006-04-18 |
| 1851380570 | Andrew S Reese | Physician Assistant | 6000 N Allen Road, Peoria, IL 61614-3294 | 2005-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760030647 | Blaine Wesley Price | Physician Assistant | 796 W Jardin Dr, Casa Grande, AZ 85122-6162 | 2019-09-03 |
| 1790347292 | James M Goldhardt | Physician Assistant | 1400 S Dobson Rd Ste A200, Mesa, AZ 85202-4707 | 2019-07-03 |
| 1972166858 | Red Heart Surgical Assisting | Physician Assistant | 43643 W Arizona Ave, Maricopa, AZ 85138-5642 | 2019-04-17 |
| 1053898833 | Sportsmedicine Outreach Specialist | Physician Assistant | 13247 N 80th Pl, Scottsdale, AZ 85260-4903 | 2018-07-24 |
| 1912496712 | Hw Surgical Assist, Pllc | Physician Assistant | 4057 E Laurel Ave, Gilbert, AZ 85234 | 2018-05-07 |
| 1346741501 | Coraesthetics Pllc | Physician Assistant | 2008 E Laguna Dr, Tempe, AZ 85282 | 2018-02-23 |
| 1366955155 | Jennifer R Osborne | Physician Assistant | 100 S Eastern Dawn Ave, Tucson, AZ 85748-1708 | 2017-11-15 |
| 1669985198 | Jacki Nichols | Physician Assistant | 5055 N Rock Canyon Rd, Tucson, AZ 85750-6003 | 2017-11-06 |
| 1720597214 | Merieme Khamsi | Physician Assistant | 14674 W Mountain View Blvrd #210, Surprise, AZ 85374 | 2017-09-27 |
| 1801305073 | Panduga Surgical Care, Pllc | Physician Assistant | 4904 S Power Rd Ste 103, Pmb 450, Mesa, AZ 85212-3610 | 2017-09-20 |
| 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.