NPIMap

Organization Active NPI

Vernon T Mackey, PC

  • Clinical & Laboratory Dermatological Immunology Physician
  • Peoria, AZ
National Provider Identifier
1003204975
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X
License
3535 Issued in AZ
Legal business name
VERNON T MACKEY, PC
Practice address
9191 W Thunderbird Rd Ste D101
Peoria, AZ 85381-4270
Phone
(623) 977-6700
Fax
(623) 977-6771
NPI assigned
Dec 31, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shelly Mackey
Title
Manager
Phone
(623) 977-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical & Laboratory Dermatological Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NI0002X 3535 AZ Primary

Addresses

Primary practice location

9191 W Thunderbird Rd Ste D101
Peoria, AZ 85381-4270

Mailing address

9191 W Thunderbird Rd Ste D101
Peoria, AZ 85381-4270
Phone (623) 977-6700

Other names 1

  • Advanced Desert Dermatology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Advanced Desert Dermatology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9191 W Thunderbird Rd
Ste D101
Peoria, AZ 85381
Phone (623) 853-3762

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1003204975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9191 W THUNDERBIRD RD STE D101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814270",
            "telephone_number": "623-977-6700",
            "fax_number": "623-977-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 W THUNDERBIRD RD STE D101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814270",
            "telephone_number": "623-977-6700",
            "fax_number": "623-977-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON T MACKEY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-31",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "MACKEY",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "623-977-6700"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "AZ",
            "license": "3535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Desert Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.