DR. ERIC A VENS M.D., NPI 1558329706 — PHOENIX (AZ)

NPI 1558329706

14+ Years Experience Individual

DR. ERIC A VENS M.D.

05.03.2006
PROVIDER ENUMERATION DATE
10/30/2014
LAST UPDATE DATE
1558329706
NPI NUMBER

About DR. ERIC A VENS

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

DR. ERIC A VENS is a provider established in PHOENIX, AZ. The NPI number of DR. ERIC A VENS is 1558329706 and was assigned on 05.03.2006. The practitioners primary taxonomy code is: 2085B0100X with license number: 32544 AZ .

Mailing address

  • City: SCOTTSDALE
  • State: AZ
  • Postal code: 852674687
  • Phone: 4809918100
  • Fax: 4809221028
  • Address: PO BOX 14687

Primary Practice Address

  • Region : PHOENIX, AZ
  • NPI : 1558329706
  • Phone : 6022488002
  • Fax : 6022488399
  • Postalcode : 850283091
  • Address : 11209 N TATUM BLVD SUITE 110

Additional identifiers

  • Identifier: AZ0324990
  • Code / Type : 1 - other
  • Identifier state : AZ
  • Identifier issuer: BCBS

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 852112
  • Code / Type : 1 - other
  • Identifier state : AZ
  • Identifier issuer : AHCCCS

Provider taxonomy - Radiology

  • Taxonomy code: 2085B0100X
  • License number: 32544
  • License state: AZ

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy description: A Radiology doctor of Osteopathy that specializes in Body Imaging.

Contacts:

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  • DR. ERIC A VENS M.D.
  • Address : 11209 N TATUM BLVD SUITE 110
  • Region : PHOENIX, AZ
  • NPI : 1558329706
  • Phone : 6022488002
  • Fax : 6022488399
  • Postalcode : 850283091

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address11209 N TATUM BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 110
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePHOENIX
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameAZ
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code850283091
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6022488002
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6022488399
The fax number associated with the location address of the provider being identified.
NPI1558329706
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 12085B0100X
A Radiology doctor of Osteopathy that specializes in Body Imaging.
Provider Enumeration Date05.03.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated10/30/2014
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. ERIC A VENS
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing AddressPO BOX 14687
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameSCOTTSDALE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameAZ
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code852674687
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number4809918100
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number4809221028
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #12085B0100X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Radiology
A Radiology doctor of Osteopathy that specializes in Body Imaging.
Provider License Number 132544
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1AZ
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 1AZ0324990
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1AZ
Other Provider Identifier State #1
Other Provider Identifier Issuer 1BCBS
Other Provider Identifier Issuer #1
Other Provider Identifier 2852112
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2AZ
Other Provider Identifier State #2
Other Provider Identifier Issuer 2AHCCCS
Other Provider Identifier Issuer #2
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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