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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
005097 | AZ | Allopathic & Osteopathic Physicians |
Street Address |
3400 N. DYSART RD BUILDING H; SUITE 131 |
City | AVONDALE |
State | AZ |
Zip Code | 85392 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730427006 | Palo Verde Dentistry | Clinic/Center | 3400 N. Dysart Rd, Ste G125, Avondale, AZ 85392 | 2013-01-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972100063 | Arizona Imaging Center, LLC | Radiology | 10825 W Mcdowell Rd Suite 130, Avondale, AZ 85392 | 2020-10-02 |
1376159053 | Quick Med Center LLC | Clinic/Center | 10825 W Mcdowell Rd Suite 100, Avondale, AZ 85392 | 2020-09-18 |
1225641046 | Ambulatory Surgery Centers, LLC | Clinic/Center | 10825 W Mcdowell Rd Suite 110, Avondale, AZ 85392 | 2020-08-31 |
1144842394 | National Cardiovascular Surgery Center, LLC | Clinic/Center | 10825 W Mcdowell Rd, Suite 310, Avondale, AZ 85392 | 2020-05-11 |
1073077145 | Lakeview Dentistry P.C., Inc. | Dentist | 10750 W. Mcdowell Road, Bldg. D410, Avondale, AZ 85392 | 2019-01-23 |
1699249458 | Elaine Van De Wille | Student in an Organized Health Care Education/Training Program | 3609 N 109th Ave, Avondale, AZ 85392 | 2019-01-15 |
1750890075 | West Valley Pediatrics | Nurse Practitioner | 10750 West Mcdowell Rd, Suite G700, Avondale, AZ 85392 | 2017-09-29 |
1336675305 | Hope-ann Kamler | Licensed Practical Nurse | 2150 North Santa Fe Blvd, Avondale, AZ 85392 | 2017-05-11 |
1790237527 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 10285 West Mcdowell Rd, Ste A-102, Avondale, AZ 85392 | 2016-10-27 |
1063969137 | Lorri Ward | Registered Nurse | 12750 W Coronado Rd, Avondale, AZ 85392 | 2016-09-07 |
Find all providers in zip 85392 |
Taxonomy Code | 2081P2900X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Physical Medicine & Rehabilitation |
Specialization | Pain Medicine |
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. |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154967750 | Pain & Wellness of Arizona, LLC | Physical Medicine & Rehabilitation | 3120 E Union Hills Dr Ste 201, Phoenix, AZ 85050-3454 | 2019-11-19 |
1831730050 | Restorative Care of Arizona, P.C. | Physical Medicine & Rehabilitation | 2150 E Highland Ave Ste 107, Phoenix, AZ 85016-4720 | 2019-09-30 |
1134785967 | Dylan Irish | Physical Medicine & Rehabilitation | 5233 E Southern Ave Ste 104, Mesa, AZ 85206-3628 | 2019-05-16 |
1134782097 | Thoroughbred Medical | Physical Medicine & Rehabilitation | 1521 E. Tangerine Road, Suite 201, Oro Valley, AZ 85755 | 2019-04-17 |
1194285387 | Apr Med Group LLC | Physical Medicine & Rehabilitation | 10605 N Hayden Rd Ste D102, Scottsdale, AZ 85260-5686 | 2019-03-22 |
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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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.