Lauren D Provencio (NPI# 1164939708, PAC ID# 0345500682) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1164939708 |
| PAC ID by PECOS | 0345500682 |
| Professional Enrollment ID | I20180207000884 |
| Full Name | Lauren D Provencio |
| Organization Legal Name | CAMELBACK MOUNTAIN SPORTS MEDICINE |
| Address |
100 E Camelback Rd Suite 120 Phoenix AZ 85012-1061 |
| Phone Number | 6028088989 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 8426953852 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 | 6028088989 | CAMELBACK MOUNTAIN SPORTS MEDICINE |
| 4800 N 44th St, Phoenix, AZ 85018-3800 | 6028088989 | CAMELBACK MOUNTAIN SPORTS MEDICINE |
| Organization Legal Name | CAMELBACK MOUNTAIN SPORTS MEDICINE |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel Joseph Nowland | Physical Therapy | Camelback Mountain Sports Medicine | 4800 N 44th St, Phoenix, AZ 85018-3800 |
| Zachary James Mcconnell | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Ashalee Cyr | Physical Therapy | Camelback Mountain Sports Medicine | 4455 E Camelback Rd, Suite D155, Phoenix, AZ 85018-2888 |
| Melissa A Ditaranto | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Jenna R Bartels | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Natalie J Semon | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Jennifer L Teslevich | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Alexandra Wickham | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Caleb Matthew Case | Physical Therapy | Camelback Mountain Sports Medicine | 4800 N 44th St, Phoenix, AZ 85018-3800 |
| Breana R Prince | Physical Therapy | Camelback Mountain Sports Medicine | 4455 E Camelback Rd, Suite D155, Phoenix, AZ 85018-2888 |
| Street Address |
100 E CAMELBACK RD SUITE 120 |
| City | PHOENIX |
| State | AZ |
| Zip | 85012-1061 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Zachary James Mcconnell | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Melissa A Ditaranto | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Jenna R Bartels | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Natalie J Semon | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Jennifer L Teslevich | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Alexandra Wickham | Physical Therapy | Camelback Mountain Sports Medicine | 100 E Camelback Rd, Suite 120, Phoenix, AZ 85012-1061 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dennis R Stjames | Physical Therapy | Dennis R. St James Physical Therapy Ltd | 532 E Maryland Ave, Suite C, Phoenix, AZ 85012-1143 |
| Justin C St James | Physical Therapy | Dennis R. St James Physical Therapy Ltd | 532 E Maryland Ave, Suite C, Phoenix, AZ 85012-1143 |
| Petrusia A Howansky | Podiatry | 520 E Bethany Home Rd, Phoenix, AZ 85012-1207 | |
| Mischa C Peck | Clinical Social Worker | 301 E Bethany Home Rd, Suite C296, Phoenix, AZ 85012-1271 | |
| Randy M Weiss | Clinical Social Worker | 301 E Bethany Home Rd, Suite 296, Phoenix, AZ 85012-1271 | |
| Heather Goodly | Anesthesiology | Valley Anesthesiology Consultants Inc | 645 E Missouri Ave, Suite 300, Phoenix, AZ 85012-1351 |
| Jennifer M Fergestad | Anesthesiology | Valley Anesthesiology Consultants Inc | 645 E Missouri Ave, Suite 300, Phoenix, AZ 85012-1351 |
| Brandon M Minzer | Anesthesiology | Valley Anesthesiology Consultants Inc | 645 E Missouri Ave, Suite 300, Phoenix, AZ 85012-1351 |
| Kelley Murphy | Certified Registered Nurse Anesthetist (crna) | Valley Anesthesiology Consultants Inc | 645 E Missouri Ave, Suite 300, Phoenix, AZ 85012-1351 |
| Drew M Davenport | Anesthesiology | Valley Anesthesiology Consultants Inc | 645 E Missouri Ave, Suite 300, Phoenix, AZ 85012-1351 |
| Find all physicians in zip 85012 | |||
| City | PHOENIX |
| Zip Code | 85012 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | PHOENIX + PHYSICAL THERAPY |
Please comment or provide details below to improve the information on Lauren D Provencio.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.