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DESSALINES SPORTS MEDICINE, LLC
NPI 1407321581
Clinic/Center in Mesa, AZ

Active since October 04, 2018
6424 E BROADWAY RD STE 102, MESA, AZ 85206(480) 634-4606 Get Directions Write a Review

NPPES record last updated: October 4, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dessalines Sports Medicine, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DESSALINES SPORTS MEDICINE, LLC (NPI 1407321581) is a healthcare organization registered as a clinic/center in Mesa, Arizona and active in the NPI registry since October 2018. The organization lists Charles Peterson, Doctor, as its authorized official.

NPPES Registry Identity

NPI1407321581
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameDESSALINES SPORTS MEDICINE, LLC
Location Address6424 E BROADWAY RD STE 102Mesa, AZ 85206-1750
Mailing Address6424 E Broadway Rd Ste 102Mesa, AZ 85206-1750 · (480) 634-4606
Phone(480) 634-4606
Organization SubpartNo
Authorized OfficialCharles PetersonDoctor · (480) 634-4606
Enumeration DateOctober 4, 2018
✔ NPI 1407321581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
6424 E BROADWAY RD STE 102, Mesa, AZ 85206
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VITO ANESTHESIA LLC
Anesthesiology
6424 E BROADWAY RD STE 102
MESA, AZ 85206
Maricopa County (480) 634-4606
PINE MONITORING LLC
Psychiatry & Neurology (Neurology)
6424 E BROADWAY RD STE 102
MESA, AZ 85206
Maricopa County (602) 354-5310
OPTIMAL TECH LLC
Clinic/Center (Health Service)
6424 E BROADWAY RD STE 102
MESA, AZ 85206
Maricopa County (480) 634-4606
PEAK SURGICAL CENTER LLC
Clinic/Center (Ambulatory Surgical)
6424 E BROADWAY RD STE 102
MESA, AZ 85206
Maricopa County (480) 634-4606
SIMPLICITY CARE ASSOCIATES LLC
Clinic/Center (Medical Specialty)
6424 E BROADWAY RD STE 102
MESA, AZ 85206
Maricopa County (480) 634-4606
GILBERTS PREMIER SURGICAL AMBULATORY CENTER LLC
Clinic/Center (Ambulatory Surgical)
6424 E BROADWAY RD STE 102
MESA, AZ 85206
Maricopa County (480) 634-4606
VERVE SURGICAL INSTITUTE, INC.
Clinic/Center (Ambulatory Surgical)
6424 E BROADWAY RD STE 102
MESA, AZ 85206
Maricopa County (602) 527-0791
SOLACE SURGERY CENTER LLC
Clinic/Center (Ambulatory Surgical)
6424 E BROADWAY RD STE 102
MESA, AZ 85206
Maricopa County (480) 634-4606

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dessalines Sports Medicine, LLC's NPI number?

The NPI number for Dessalines Sports Medicine, LLC is 1407321581. It was assigned to this organization in the NPPES registry on October 4, 2018.

Where is Dessalines Sports Medicine, LLC located?

Dessalines Sports Medicine, LLC is located at 6424 E Broadway Rd Ste 102, Mesa, AZ 85206. The listed phone number is (480) 634-4606.

What is Dessalines Sports Medicine, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Dessalines Sports Medicine, LLC was last updated on October 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.