NPIMap

Organization Active NPI

Maricopa County Special Health Care District

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1003233180
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
H3673 Issued in AZ
Legal business name
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Practice address
2525 E Roosevelt St
Phoenix, AZ 85008-4948
Phone
(602) 344-8180
NPI assigned
Mar 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Authorized official

Name
Kathleen Kirkland
Title
PFS Director
Phone
(602) 344-8178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X H3673 AZ Primary

Addresses

Primary practice location

2525 E Roosevelt St
Phoenix, AZ 85008-4948

Mailing address

PO Box 29670
Phoenix, AZ 85038-9670
Phone (602) 344-8180

Other identifiers 7

IdentifierTypeStateIssuer
631935OtherAZAETNA
AZ0205850OtherAZBLUE CROSS BLUE SHIELD
AZ0947OtherAZHEALTHNET OF AZ
500005OtherAZEVERCARE CHOICE
29517OtherAZPHOENIX INDIAN MEDICAL CENTER
189350800OtherAZUS DEPT OF LABOR
987487MedicaidAZ

Other names 1

  • Dialysis Center at Valleywise Comprehensive Care Center - Phoenix Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060628000355 AZ Part A Provider - End-Stage Renal Disease Facility (ESRD) 4688583651 1 other NPI on this enrollment
Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Maricopa Integrated Health System23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Valleywise HealthPhoenix, AZ, CCN 03S022 Hospital Operational/Managerial Control Jan 1, 2005
Valleywise HealthPhoenix, AZ, CCN 030022 Hospital Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Comprehensive Health Center - PeoriaPeoria, AZ, CCN 031073 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - McDowellPhoenix, AZ, CCN 031065 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Health Community Health Center - GuadalupeGuadalupe, AZ, CCN 031066 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - North PhoenixPhoenix, AZ, CCN 031067 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - West MaryvalePhoenix, AZ, CCN 031075 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Comprehensive Health Center - PhoenixPhoenix, AZ, CCN 031072 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - South Phoenix LaveenPhoenix, AZ, CCN 031071 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - ChandlerChandler, AZ, CCN 031082 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - AvondaleAvondale, AZ, CCN 031080 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - MesaMesa, AZ, CCN 031074 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - South CentralPhoenix, AZ, CCN 031083 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005

Owned or controlled facilities with NPI records 18

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 18

Practitioners 124

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

View all 124

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588550400000",
    "number": "1003233180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29670",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389670",
            "telephone_number": "602-344-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E ROOSEVELT ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850084948",
            "telephone_number": "602-344-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-26",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A",
        "authorized_official_last_name": "KIRKLAND",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PFS DIRECTOR",
        "authorized_official_telephone_number": "602-344-8178"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "AZ",
            "license": "H3673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "631935",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0205850",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET OF AZ",
            "identifier": "AZ0947",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE CHOICE",
            "identifier": "500005",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHOENIX INDIAN MEDICAL CENTER",
            "identifier": "29517",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "189350800",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "987487",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dialysis Center at Valleywise Comprehensive Care Center - Phoenix",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.