1235800897 NPI number — ROBERTS KAMP & ASSOCIATES PLLC

Table of content: (NPI 1235800897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235800897 NPI number — ROBERTS KAMP & ASSOCIATES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERTS KAMP & ASSOCIATES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235800897
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5717 E THOMAS RD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85251-7620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-866-8811
Provider Business Mailing Address Fax Number:
602-429-8200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1701 SE GREENVILLE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27858-4811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-607-9999
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2021

Additional Information

Authorized Official

Authorized Official Last Name:
ZWICKY
Authorized Official First Name:
TERESA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING & ENROLLMENT MANAGER
Authorized Official Telephone Number:
480-866-8811

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223X0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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