NPIMap

Organization Active NPI

Ternion Physician Group, PLLC

  • Internal Medicine Physician
  • Anthem, AZ
National Provider Identifier
1013466192
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TERNION PHYSICIAN GROUP, PLLC
Practice address
42104 N Venture Dr
Suite D118
Anthem, AZ 85086-3823
Phone
(623) 505-9880
Fax
(623) 505-9880
NPI assigned
Sep 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Liliana Perez
Title
Practice Manager
Phone
(623) 505-9880

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

42104 N Venture Dr
Suite D118
Anthem, AZ 85086-3823

Mailing address

42104 N Venture Dr
Suite D118
Anthem, AZ 85086-3823
Phone (623) 505-9880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170814001018 AZ Part B Supplier - Clinic/Group Practice 6709157589 Receives reassigned benefits from 38 practitioners
Practice locations: Glendale, AZ

National Provider Directory

National Provider Directory

Locations

3655 W Anthem Way
Ste A109
Anthem, AZ 85086
Phone (623) 505-4479

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Health Group ManagementFlagstaff, AZ, CCN 035091 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2021
Jan 23, 2025
Haven of SedonaSedona, AZ, CCN 035094 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 23, 2025
Jan 23, 2025

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1013466192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42104 N VENTURE DR",
            "address_2": "SUITE D118",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850863823",
            "telephone_number": "623-505-9880",
            "fax_number": "623-505-9880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42104 N VENTURE DR",
            "address_2": "SUITE D118",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850863823",
            "telephone_number": "623-505-9880",
            "fax_number": "623-505-9880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERNION PHYSICIAN GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-29",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "LILIANA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "623-505-9880"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anthem, AZ

Sources for this page

Verify at the official NPI Registry.