CMS-1500 Box 24J / 33a • NPI
1023245461
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207LP2900X (CMS 05)
Board-Certified Anesthesiologist & Interventional Pain Specialist
Box 32 Service Location & ZIP+4
114 S MOUNTAIN AVE, WHITE MOUNTAIN SPECIALTY CLINIC, SPRINGERVILLE, AZ, 85938-5104
✓ 9-Digit EDI 837 ZIP+4 (85938-5104)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1023245461 (SUNRISE ANESTHESIA & PAIN MANAGEMENT, PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1023245461 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | SUNRISE ANESTHESIA & PAIN MANAGEMENT, PLLC |
| Plain-English Specialty | Board-Certified Anesthesiologist & Interventional Pain Specialist NUCC Code: 207LP2900X (Anesthesiology, Pain Medicine) |
| Certifying / Licensing Body | American Board of Anesthesiology (ABA) |
| Practice Location Address | 114 S MOUNTAIN AVE, WHITE MOUNTAIN SPECIALTY CLINIC, SPRINGERVILLE, AZ, 85938-5104 |
| Practice Telephone / Fax | Tel: (928) 468-3132 | Fax: (888) 717-3257 |
| Administrative Mailing Address | PO BOX 1917, SPRINGERVILLE, AZ, 85938-1917 |
| Enumeration & Last Sync | Enumerated: 2009-06-11 | CMS Record Updated: 2011-09-13 |
| Authorized Official | JOHN ALLEN (Executive Director) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207LP2900X)
What Does Taxonomy Code 207LP2900X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207LP2900X translates to:
"Board-Certified Anesthesiologist & Interventional Pain Specialist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (SUNRISE ANESTHESIA & PAIN MANAGEMENT, PLLC)
Typical CPT / Diagnostic Procedures:- General Endotracheal Anesthesia & Total Intravenous Anesthesia (TIVA)
- Ultrasound-Guided Peripheral Nerve Blocks & Labor Epidural Analgesia
- Fluoroscopic Epidural Steroid Injections & Facet Joint Blocks
- Propofol, Sevoflurane, Rocuronium & Sugammadex
- Bupivacaine, Lidocaine & Ropivacaine Regional Anesthetics
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
208VP0014X — Pain Medicine, Interventional Pain MedicinePlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Pain Medicine, Interventional Pain Medicine | State: AZ | License: Fellow, CPP #8633 | Primary: Secondary |
367500000X — Nurse Anesthetist, Certified RegisteredPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Anesthetist, Certified Registered | State: AZ | License: CRNA0632 | Primary: Secondary |
207LP2900X — Anesthesiology, Pain MedicinePlain English: Board-Certified Anesthesiologist & Interventional Pain Specialist | State: AZ | License: Fellow,CPP #8633 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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