SCOTTSDALE MEDICAL INNOVATIONS, LLC (NPI# 1457883142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457883142 |
| Entity Type | Organization |
| Organization Name | SCOTTSDALE MEDICAL INNOVATIONS, LLC |
| Practice Address |
7010 E Chauncey Ln Suite 215 Phoenix AZ 85054-3111 |
| Practice Telephone | 4803142288 |
| Practice Fax Number | 4803141113 |
| Mailing Telephone | 4803142288 |
| Mailing Fax Number | 4803141113 |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |
| Authorized Official Name | DR. SHAM VENGURLEKAR (SOLE MEMBER/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4803140821 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Street Address |
7010 E CHAUNCEY LN SUITE 215 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85054-3111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497753750 | Rajeev Agarwal | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2005-07-11 |
| 1386186351 | Jessica Etchells | Physician Assistant | 7010 E Chauncey Ln, Phoenix, AZ 85054 | 2016-11-08 |
| 1407225733 | Stephanie Marie Poterack | Nurse Practitioner | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054-3111 | 2015-09-16 |
| 1851715106 | Kimberly Birch | Physician Assistant | 7010 E Chauncey Ln, Suite 210, Phoenix, AZ 85054-3111 | 2014-02-06 |
| 1316291479 | Stacey Michelle Hopper | Nurse Practitioner | 7010 E Chauncey Ln, Suite 145, Phoenix, AZ 85054-3111 | 2012-10-28 |
| 1124271598 | Diane Michele Smith | Nurse Practitioner | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2008-10-29 |
| 1710136809 | Rebecca Joyce Hogan | Nurse Practitioner | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054-3117 | 2008-09-12 |
| 1053577502 | Nichole Lee Thomas | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2008-08-04 |
| 1316106263 | Rachael Beth Blumenthal | Pediatrics | 7010 E Chauncey Ln, Ste 225, Phoenix, AZ 85054-3111 | 2008-06-05 |
| 1831373562 | Agnes Ida Bartha | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054-3111 | 2007-12-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992255301 | Stephanie Gamber | Registered Nurse | 5405 East Pinnacle Vista Drive, Phoenix, AZ 85054 | 2016-10-10 |
| 1508231960 | Deborah Elam | Acupuncturist | 5777 East Mayo Boulevard Mayo Clinic, Phoenix, AZ 85054 | 2015-12-09 |
| 1811176860 | Desert Ridge Pediatric Dentistry | Clinic/Center | 5315 E. High Street, Suite 115, Phoenix, AZ 85054 | 2007-10-26 |
| 1902968639 | Ryan David Schulze | Chiropractor | 7000 E Mayo Blvd Ste 1058, Phoenix, AZ 85054 | 2006-12-16 |
| 1477517423 | Gary Betz II Md PC | Internal Medicine | 7010 E. Chauncey Lane, Suite 145, Phoenix, AZ 85054 | 2006-04-14 |
| 1689658395 | Alice G Mccormick | Internal Medicine | 5450 East Deer Valley Drive Unit 3206, Phoenix, AZ 85054 | 2005-12-06 |
| 1770576241 | Michelle Renee Kuhn | Physician Assistant | 6950 E Chauncey Ln, Phoenix, AZ 85054 | 2005-08-30 |
| 1609869981 | Jeffrey Alan Smith | Optometrist | 18325 N Allied Way Ste 100, Phoenix, AZ 85054 | 2005-08-23 |
| 1043219389 | Hasan Khamash | Internal Medicine | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2005-07-19 |
| 1740283878 | Charles J Manak | Internal Medicine | 5777 E Mayo Blvd, Phoenix, AZ 85054 | 2005-05-23 |
| Find all providers in zip 85054 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376020685 | Andoloris Medical, Pllc | Clinic/Center | 3417 N 32nd St Ste B, Phoenix, AZ 85018-5606 | 2018-07-19 |
| 1669994539 | Valley Wellness Center Pllc | Clinic/Center | 702 E Bell Rd Ste 112, Phoenix, AZ 85022 | 2017-07-12 |
| 1013359165 | West Valley Pain Solutions, LLC | Clinic/Center | 9140 W Thomas Rd, Suite B-106, Phoenix, AZ 85037-3378 | 2013-07-17 |
| 1376703314 | Valley Pain Centers, LLC | Clinic/Center | 4045 E Bell Rd Ste 147, Phoenix, AZ 85032 | 2008-06-12 |
| 1316114663 | Southwest Comprehensive Pain Management LLC | Clinic/Center | 1749 W Bramble Berry Ln, Phoenix, AZ 85085-8044 | 2008-05-14 |
| 1255979332 | Phoenix Pain Treatment Centers, Pllc | Clinic/Center | 9140 W Thomas Rd Ste B-106, Phoenix, AZ 85037-3378 | 2019-12-19 |
| 1922570332 | Summit View Physician Partners, LLC | Clinic/Center | 7010 E Chauncey Ln Ste 215, Phoenix, AZ 85054-3117 | 2018-12-24 |
| 1740752542 | Blue Star Surgical Partners, LLC | Clinic/Center | 7010 E Chauncey Ln Ste 215, Phoenix, AZ 85054-3117 | 2018-12-19 |
| 1962970327 | Phoenix Outpatient Surgery Center LLC | Clinic/Center | 1301 E Mcdowell Rd Ste 100, Phoenix, AZ 85006-2605 | 2018-11-05 |
| 1821565474 | Pd Ambulatory Pain Treatment Center, LLC | Clinic/Center | 1301 E Mcdowell Rd Ste 100, Phoenix, AZ 85006-2605 | 2018-10-31 |
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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.