ARIZONA IOM LLC (NPI# 1831577139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831577139 |
| Entity Type | Organization |
| Organization Name | ARIZONA IOM LLC |
| Practice Address |
2301 West Sanoque Court Gilbert AZ 85298 |
| Mailing Address |
2907 Shelter Island Dr. Suite 105-612 San Diego CA 92106-2743 |
| Practice Telephone | 7205035711 |
| Mailing Telephone | 6027341405 |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2018-10-10 |
| Authorized Official Name | MATTHEW L. FORDYCE (MANAGING PARTNER) |
| Authorized Official Telephone | 6194586306 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
2301 WEST SANOQUE COURT |
| City | GILBERT |
| State | AZ |
| Zip Code | 85298 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891227021 | Shay Petillo | Specialist/Technologist, Other | 2301 West Sanoque Court, Gilbert, AZ 85298 | 2017-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629614623 | Katherine Elizabeth Reynolds | Nurse Practitioner | 1956 E. Azalea Ct., Gilbert, AZ 85298 | 2019-11-25 |
| 1972023281 | Jamie Lynn Williams | Specialist/Technologist | 2216 E Brigadier Dr, Gilbert, AZ 85298 | 2017-06-27 |
| 1891233896 | Gabbrielle Rene Knabe | Nurse Practitioner | 3336 East Chandler Heights Road Ste 132, Sundance Medical Associates, Gilbert, AZ 85298 | 2017-02-09 |
| 1508212580 | Better Horizons LLC | Community Based Residential Treatment Facility, Mental Illness | 3030 E Sports Court, Gilbert, AZ 85298 | 2016-05-10 |
| 1952766602 | Ji Yong Kim | Specialist/Technologist, Other | 2301 West Sanoque Ct, Gilbert, AZ 85298 | 2015-12-23 |
| 1043675838 | Clarisse Kamgaing | Psychologist | 2442 E. Eleana Lane, Gilbert, AZ 85298 | 2015-12-21 |
| 1306268164 | Jessica O'neil | Licensed Practical Nurse | 6930 South Seville Blvd E, Gilbert, AZ 85298 | 2014-01-14 |
| 1548696164 | James Holloway | Chiropractor | 4828 S Val Vista Dr, Gilbert, AZ 85298 | 2013-09-16 |
| 1457685174 | Carrie Jennifer Malachowski | Social Worker | 4115 E. Saraband Way, Gilbert, AZ 85298 | 2009-09-29 |
| 1942434543 | Rnp Nurses Inc | Nursing Care | 1441 E Chestnut Ln, Gilbert, AZ 85298 | 2009-05-11 |
| Find all providers in zip 85298 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366987265 | Jing Zhang | Specialist/Technologist, Other | 2301 E Sanoque Ct, Gilbert, AZ 85298-6124 | 2016-12-31 |
| 1952766602 | Ji Yong Kim | Specialist/Technologist, Other | 2301 West Sanoque Ct, Gilbert, AZ 85298 | 2015-12-23 |
| 1912525585 | Arizona Monitoring LLC | Specialist/Technologist, Other | 2301 E Sanoque Ct, Gilbert, AZ 85298-6124 | 2020-07-10 |
| 1366914418 | Nya Sartirana | Specialist/Technologist, Other | 2301 E Sanoque Ct, Gilbert, AZ 85298-6124 | 2018-12-28 |
| 1891227021 | Shay Petillo | Specialist/Technologist, Other | 2301 West Sanoque Court, Gilbert, AZ 85298 | 2017-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720688294 | Kathy Hoang | Specialist/Technologist, Other | 2131 E Broadway Rd Ste 22, Tempe, AZ 85282-1737 | 2020-10-26 |
| 1609492743 | Alberto Aguilar Rodriguez | Specialist/Technologist, Other | 21012 S 194th St, Queen Creek, AZ 85142-8804 | 2020-06-24 |
| 1982199915 | Donna Lowe | Specialist/Technologist, Other | 5115 N Dysart Rd # 202-197, Litchfield Park, AZ 85340-3032 | 2018-06-22 |
| 1235665050 | Allegiant Diagnostics, LLC | Specialist/Technologist, Other | 15508 W Bell Rd Ste 101, Pmb #411, Surprise, AZ 85374-2432 | 2017-05-11 |
| 1093257305 | Meagan Re | Specialist/Technologist, Other | 3131 N 70th St, Scottsdale, AZ 85251-6383 | 2016-11-17 |
| 1699217919 | Christopher Townsend | Specialist/Technologist, Other | 7161 E Rancho Vista Dr, Unit 4005, Scottsdale, AZ 85251-1495 | 2016-11-17 |
| 1588112072 | Standard Iom, LLC | Specialist/Technologist, Other | 5115 N Dysart Rd Ste 202 #197, Litchfield Park, AZ 85340-3036 | 2016-09-14 |
| 1295283794 | Standard Monitoring LLC | Specialist/Technologist, Other | 5115 N Dysart Rd Ste 202 No 197, Litchfield Park, AZ 85340-3036 | 2016-09-14 |
| 1679920961 | Spine Ionm, LLC | Specialist/Technologist, Other | 8326 W Corrine Dr, Peoria, AZ 85381-5171 | 2016-05-17 |
| 1407202989 | Jeremy Burress | Specialist/Technologist, Other | 2451 Seabring Dr, Lake Havasu City, AZ 86403-3156 | 2016-05-13 |
| 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.