ATLANTIS CARDIAC & VASCULAR CENTER OF SURPRISE, LLC (NPI# 1255817847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255817847 |
| Entity Type | Organization |
| Organization Name | ATLANTIS CARDIAC & VASCULAR CENTER OF SURPRISE, LLC |
| Practice Address |
12361 W Bola Dr Surprise AZ 85378-9021 |
| Mailing Address |
50 E Rio Salado Pkwy Tempe AZ 85281-9102 |
| Practice Telephone | 6238155000 |
| Mailing Telephone | 4809672037 |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2018-07-17 |
| Authorized Official Name | TIMOTHY COZATT (COO) |
| Authorized Official Telephone | 4803958211 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
12361 W BOLA DR |
| City | SURPRISE |
| State | AZ |
| Zip Code | 85378-9021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912990094 | Robert C Waldrip | Orthopaedic Surgery | 12361 W Bola Dr, Suite 100, Surprise, AZ 85378-9021 | 2005-08-24 |
| 1417497066 | Nicole Barth | Nurse Practitioner | 12361 W Bola Dr, Suite 109, Surprise, AZ 85378-9021 | 2017-03-01 |
| 1881132314 | Laurel Sockrider | Nurse Practitioner | 12361 W Bola Dr, Suite 109, Surprise, AZ 85378-9021 | 2017-02-04 |
| 1598125791 | Raghav LLC | Psychiatry & Neurology | 12361 W Bola Dr, Ste 109, Surprise, AZ 85378-9021 | 2016-03-01 |
| 1528496411 | Travis S Jensen Dpm PC | Podiatrist | 12361 W Bola Dr, Surprise, AZ 85378-9021 | 2013-10-31 |
| 1538500046 | Joseph M Janzer, Do PC | Orthopaedic Surgery | 12361 W Bola Dr, Surprise, AZ 85378-9021 | 2013-07-12 |
| 1457792962 | Lawrence Kelly, Md PC | Orthopaedic Surgery | 12361 W Bola Dr, Surprise, AZ 85378-9021 | 2013-07-12 |
| 1962841742 | The Ortho Joint of Arizona, LLC | Orthopaedic Surgery | 12361 W Bola Dr, #100, Surprise, AZ 85378-9021 | 2013-06-14 |
| 1538429121 | Sr Billing | Anesthesiology | 12361 W Bola Dr, Suite 109, Surprise, AZ 85378 | 2012-05-17 |
| 1417215377 | Orthopedic Specialists of North America, Pllc | Orthopaedic Surgery | 12361 W Bola Dr, Ste 100, Surprise, AZ 85378-9021 | 2012-04-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467947101 | Destiny Springs Healthcare, LLC | Psychiatric Hospital | 17300 N. Dysart Road, Surprise, AZ 85378 | 2018-06-26 |
| 1881013480 | Amanda Brimlow | Specialist | 12425 West Bell Rd, Suite 200, Surprise, AZ 85378 | 2014-04-10 |
| 1598193104 | Kalin Marie Harding | Nurse Practitioner | 12425 W. Bell Rd., Suite 106, Suprise, AZ 85378 | 2013-10-16 |
| 1043651540 | Rachel Sara Herrin | Internal Medicine | 12665 W. Smokey Dr., #140, Surprise, AZ 85378 | 2013-07-12 |
| 1962756528 | Daniel Allen Dryer | Registered Nurse | 11607 W. Mingus Mt. Ct., Surprise, AZ 85378 | 2012-11-05 |
| 1124374715 | Rabeca Vatamaniuc | Home Health Aide | 11151 W Lily Mckinley Dr, Surprise, AZ 85378 | 2012-08-01 |
| 1710073457 | Arizona's Children Association | Clinic/Center | 11321 West Bell Road, Suite 401, Surprise, AZ 85378 | 2006-10-04 |
| 1457515579 | Madhuri Dhupati & Associates Md PC. | Clinic/Center | 12647 W Smokey Dr Ste 119, Surprise, AZ 85378 | 2008-07-17 |
| 1205267119 | Post-acute Physicians of Arizona Pllc | Physical Medicine & Rehabilitation | 13060 W Bell Rd, Surprise, AZ 85378-1200 | 2013-12-02 |
| 1679954002 | Cobalt Rehabilitation Hospital Iv, LLC | Rehabilitation Hospital | 13060 W Bell Rd, Surprise, AZ 85378-1200 | 2015-06-11 |
| Find all providers in zip 85378 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619959970 | Limor Philipp Wall | Surgery | 15571 North Reems Road, Surprise, AZ 85374 | 2005-11-14 |
| 1811997513 | Marc Lewis Eckhauser | Surgery | 15571 N Reems Rd, Surprise, AZ 85374-9584 | 2005-07-26 |
| 1902312317 | Pinnacle Vein and Vascular Center Pllc | Surgery | 12361 W Bola Dr Ste 100, Surprise, AZ 85378-9021 | 2017-12-20 |
| 1164970968 | Nhc Arizona Professional Associates LLC | Surgery | 15571 N Reems Rd, Surprise, AZ 85374-9584 | 2016-09-21 |
| 1083999361 | Arizona Vein and Vascular Center LLC | Surgery | 15571 N Reems Rd, Surprise, AZ 85374-9584 | 2011-10-18 |
| 1396917761 | L Philipp Wall Md PC | Surgery | 15571 N Reems Rd, Surprise, AZ 85374-9584 | 2008-03-26 |
| 1063632149 | Stephen Troy Smith | Surgery | 12361 W Bola Dr Ste 100, Surprise, AZ 85378-9021 | 2007-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073127858 | Flagstaff Pain and Treatment Center LLC | Surgery | 823 N San Francisco St, Flagstaff, AZ 86001-3294 | 2020-08-31 |
| 1013531268 | Honorhealth Ambulatory | Surgery | 6220 W Bell Rd Ste 120, Glendale, AZ 85308-3896 | 2020-06-03 |
| 1649894890 | Honorhealth Ambulatory | Surgery | 9250 N 3rd St Ste 2000, Phoenix, AZ 85020-2403 | 2020-06-03 |
| 1275157414 | Honorhealth Ambulatory | Surgery | 18404 N Tatum Blvd Ste 201, Phoenix, AZ 85032-1508 | 2020-06-03 |
| 1568025617 | Caronae Howell | Surgery | University of Arizona/vascular Surgery Section, 1501 N. Campbell Ave., Room 4402, Tucson, AZ 85724 | 2019-04-15 |
| 1790144889 | Scottsdale Healthcare Corporation | Surgery | 7301 E Osborn Rd., Suite 100, Scottsdale, AZ 85251 | 2016-02-17 |
| 1588061535 | Eugene Melvin Zweiback Md | Surgery | 7619 E Nogales Road, Scottsdale, AZ 85258 | 2014-11-19 |
| 1821434184 | Rio Vista Surgical Associates P.C. | Surgery | 1200 Mohave Dr, Parker, AZ 85344 | 2013-05-14 |
| 1275876518 | Sara Catherine Mckeever | Surgery | 6565 E Carondelet Dr Ste 235, Tucson, AZ 85710-3533 | 2013-04-05 |
| 1689928061 | Michael Arthur Davis | Surgery | 2744 Silver Creek Rd, Bullhead City, AZ 86442-7913 | 2012-11-06 |
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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.