ACTIVE LIFE PHYSICAL MEDICINE & PAIN CENTER, PLLC


Address: 3400 N. Dysart Rd, Building H; Suite 131, Avondale, AZ 85392
Phone: 6235359777

ACTIVE LIFE PHYSICAL MEDICINE & PAIN CENTER, PLLC (NPI# 1811130016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811130016
Entity Type Organization
Organization Name ACTIVE LIFE PHYSICAL MEDICINE & PAIN CENTER, PLLC
Practice Address 3400 N. Dysart Rd
Building H; Suite 131
Avondale
AZ 85392
Practice Telephone 6235359777
Practice Fax Number 6235359778
Mailing Telephone 6235359777
Mailing Fax Number 6235359778
Enumeration Date 2009-04-17
Last Update Date 2009-04-17
Authorized Official Name DR. WENDI LUNDQUIST (OWNER/PHYSICIAN)
Authorized Official Telephone 6235359777
Authorized Official Credential D.O.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2081P2900X Physical Medicine & Rehabilitation
Specialization: Pain Medicine
005097 AZ Allopathic & Osteopathic Physicians

Office Location

Street Address 3400 N. DYSART RD
BUILDING H; SUITE 131
City AVONDALE
State AZ
Zip Code 85392

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Taxonomy Information

Taxonomy Code 2081P2900X
Grouping Allopathic & Osteopathic Physicians
Classification Physical Medicine & Rehabilitation
Specialization Pain Medicine

Taxonomy Definition

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1801847546 Wendi Joy Lundquist Physical Medicine & Rehabilitation 3400 N. Dysart Rd., Suite H131, Avondale, AZ 85392-1012 2006-05-15

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NPI Name Taxonomy Address Enumeration
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1932683919 Gemma Justice Lopez Physical Medicine & Rehabilitation 22321 E Cherrywood Dr, Queen Creek, AZ 85142-4827 2018-09-17
1003325945 North Scottsdale Pro Physical Medicine & Rehabilitation 8952 E Desert Cove Ave Ste 103, Scottsdale, AZ 85260-6776 2017-09-22
1518496702 Saa Healthcare LLC Physical Medicine & Rehabilitation 6320 W Union Hills Dr Ste 1400b, Glendale, AZ 85308-1061 2017-06-09
1760815237 Dr Sheba Jilani Physical Medicine & Rehabilitation 4515 S Mcclintock Dr Ste 118, Tempe, AZ 85282-7381 2013-08-19
1437437605 M S C Holding Group LLC Physical Medicine & Rehabilitation 1640 S Stapley Dr, Suite 245, Mesa, AZ 85204-6667 2011-07-22
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Competitor

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City AVONDALE
Zip Code 85392

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Dataset Information

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.

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