SAG, LLC (NPI# 1033359419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033359419 |
| Entity Type | Organization |
| Organization Name | SAG, LLC |
| Other Organization Name | CENTER FOR PAIN CONTROL |
| Practice Address |
3306 W Roosevelt St Phoenix AZ 85009-3404 |
| Mailing Address |
4220 N 20th Ave Phoenix AZ 85015-5124 |
| Practice Telephone | 6028899401 |
| Practice Fax Number | 6022697772 |
| Mailing Telephone | 6028899401 |
| Mailing Fax Number | 6028899404 |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2020-08-27 |
| Authorized Official Name | ROSE MATA-ESPINOZA (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 6026878219 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP3300X |
Clinic/Center Specialization: Pain |
========= | AZ | Ambulatory Health Care Facilities |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 444776 | 05 |
| Other Name | Type Code |
|---|---|
| Center for Pain control | Doing Business As Name - Organization |
| Center For Pain Control | Other Name - Individual/Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4220 N 20th Ave, Phoenix, AZ 850155124 | 6028899401 | 6028899404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548597941 | Sag, LLC | Pain Medicine | 3306 W Roosevelt St, Phoenix, AZ 85009-3404 | 2009-11-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | SAG, LLC | 22502 Ne 9th Drive, Sammamish, WA 98074 |
| Colorado Business Entities | SAG, LLC | 5940 Paonia Ct, Colorado Springs, CO 80915 |
| Oregon Corporations, Companies and Business Names | SAG, LLC | 6297 Nicklaus Lp N, Salem, OR 97303 |
| Oklahoma Business Registrations | SAG, LLC | 1818 Southerly Ridge, Edmond, OK 73025 |
| Vermont Business Registrations | SAG, LLC | 238 Taber Ridge Road, Stowe, VT 05672 |
| Street Address |
3306 W ROOSEVELT ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85009-3404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588635643 | James Lea Ali | Physician Assistant | 3306 W Roosevelt St, Phoenix, AZ 85009-3404 | 2006-01-27 |
| 1922644012 | Elicia Hinton | Family Medicine | 3306 W Roosevelt St, Phoenix, AZ 85009-3404 | 2019-11-23 |
| 1265981666 | Your Neighborhood Dental Care LLC | Dentist | 3306 W Roosevelt St, Phoenix, AZ 85009-3404 | 2016-09-26 |
| 1023566817 | Kendal Packer | Physician Assistant | 3306 W Roosevelt St, Phoenix, AZ 85009-3404 | 2016-09-21 |
| 1356792410 | Melissa Morrison | Nurse Practitioner | 3306 W Roosevelt St, Ste. A, Phoenix, AZ 85009-3404 | 2016-06-29 |
| 1336455450 | Robin K Lee | Physician Assistant | 3306 W Roosevelt St, Phoenix, AZ 85009-3404 | 2010-08-26 |
| 1548597941 | Sag, LLC | Pain Medicine | 3306 W Roosevelt St, Phoenix, AZ 85009-3404 | 2009-11-06 |
| 1245423789 | Family Practice Clinic Ltd | Family Medicine | 3306 W Roosevelt St, Ste A, Phoenix, AZ 85009-3404 | 2007-08-18 |
| 1699828723 | Charles Eugene Myers | Family Medicine | 3306 W Roosevelt St, Suite A, Phoenix, AZ 85009-3404 | 2007-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220065 | Ashley Medeiros | Specialist/Technologist | 2926 E. Encanto Blvd., Phoenix, AZ 85009 | 2020-09-16 |
| 1326252909 | Raul Herreras | Speech-Language Pathologist | 3101 W. Mcdowell Road, Phoenix, AZ 85009 | 2007-05-10 |
| 1295956779 | Gerardo Gaerlan Gregorio | Internal Medicine | 3250 W. Lower Buckeye Road, Phoenix, AZ 85009 | 2007-05-01 |
| 1316060338 | Eve Ronnie Davidson | Registered Nurse | 3333wroosevelt, Phoenix, AZ 85009 | 2007-04-06 |
| 1679693808 | Paul Thomas Lorentsen | Internal Medicine | 1929 W. Fillmore St, Bldg C, The Neighborhood Christian Clinic, Phoenix, AZ 85009 | 2007-03-30 |
| 1134246655 | Audrea J Chambers-pryce | Registered Nurse | 3715 W Roosevelt, Phx, AZ 85009 | 2007-03-22 |
| 1053437582 | Monique Marie Knepper | Licensed Practical Nurse | 3025 W Mc Dowell Rd, Phoenix, AZ 85009 | 2007-03-22 |
| 1245356054 | Lena Rose Felder | Speech-Language Pathologist | 3348 W. Mcdowell Rd., Phoenix, AZ 85009 | 2007-03-22 |
| 1508900036 | Walter M Wood | Psychologist | 3348 W Mcdowell Road, Phoenix, AZ 85009 | 2007-02-17 |
| 1194869982 | Maureen Brukardt | Registered Nurse | 3449 N 39th Ave, Phx, AZ 85009 | 2007-02-16 |
| Find all providers in zip 85009 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679070379 | Dessert Ridge Professional LLC | Pain Medicine | 21001 N Tatum Blvd Ste 78-1640, Phoenix, AZ 85050-5244 | 2018-04-09 |
| 1982124582 | Phoenix Pain Treatment Centers, Pllc | Pain Medicine | 9140 W Thomas Rd Ste B-106, Phoenix, AZ 85037-3378 | 2017-06-23 |
| 1831535350 | Ankit Patel | Pain Medicine | 1641 E Osborn Rd Ste 6, Phoenix, AZ 85016-7146 | 2013-05-13 |
| 1578181137 | Innovative Pain and Wellness Plc | Pain Medicine | 2340 E Beardsley Rd Ste 120, Phoenix, AZ 85024-1286 | 2020-07-10 |
| 1265052989 | Biltmore Med Group LLC | Pain Medicine | 3001 E Camelback Rd Ste 155, Phoenix, AZ 85016-4433 | 2020-04-22 |
| 1083246805 | Dv Professional Group LLC | Pain Medicine | 21001 N Tatum Blvd Ste 78-1640, Phoenix, AZ 85050-5244 | 2020-02-10 |
| 1043850324 | Tatum Professional Group LLC | Pain Medicine | 21001 N Tatum Blvd Ste 78-1640, Phoenix, AZ 85050-5244 | 2020-01-14 |
| 1720549090 | Virtuous Medical Associates, LLC | Pain Medicine | 2730 W Agua Fria Fwy Ste 103, Phoenix, AZ 85027-7202 | 2019-03-28 |
| 1114499472 | Iridium Pain Management Pllc | Pain Medicine | 4045 E Bell Rd Ste 147, Phoenix, AZ 85032-2239 | 2018-12-27 |
| 1013489350 | Pain Solutions of Arizona Pllc | Pain Medicine | 9140 W Thomas Rd Ste B-106, Phoenix, AZ 85037-3378 | 2018-12-27 |
| Find all providers in PHOENIX | ||||
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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.