NPI Code Detail JSON Logo

1821989708 NPI number — SOUTHERN ARIZONA LIMB PRESERVATION CENTER LLC

NPI Number: 1821989708
Health Care Provider/Practitioner: SOUTHERN ARIZONA LIMB PRESERVATION CENTER LLC

Information about “1821989708” NPI (SOUTHERN ARIZONA LIMB PRESERVATION CENTER LLC) exists in 1821989708 in HTML format HTML  |  1821989708 in plain Text format TXT  |  1821989708 in PDF (Portable Document Format) PDF  |  1821989708 in an XML format XML  formats.

NPI Number : 1821989708 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821989708",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SOUTHERN ARIZONA LIMB PRESERVATION CENTER LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "6130 N LA CHOLLA BLVD STE 111",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TUCSON",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85741-3589",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "310-919-9560",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6130 N LA CHOLLA BLVD STE 111",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TUCSON",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85741-3589",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "310-919-9560",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/10/2025",
    "LastUpdateDate": "07/10/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BOONE",
    "AuthorizedOfficialFirstName": "DIANE",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "MANAGING MEMBER",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RN MS",
    "AuthorizedOfficialTelephoneNumber": "310-919-9560",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163WW0000X",
          "TaxonomyName": "Wound Care Registered Nurse",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2086S0129X",
          "TaxonomyName": "Vascular Surgery Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "213E00000X",
          "TaxonomyName": "Podiatrist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2083P0011X",
          "TaxonomyName": "Undersea and Hyperbaric Medicine (Preventive Medicine) Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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