Alliance With the Covenant of the Trinity Arizona Inc

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

Legal business name

ALLIANCE WITH THE COVENANT OF THE TRINITY ARIZONA INC

Practice address

2 N Central Ave FL 18
Phoenix, AZ 85004-2322

Phone

(213) 709-0777

NPI assigned

Nov 12, 2019

Organization subpart

No

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

Authorized official

Name

Zandra Gonzales

Title

Cfo/Coo

Phone

(213) 709-0777

Specialties & licenses 1

Addresses

Other names 1

• ACT Medical Group Arizona Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573516800000",
    "number": "1013552124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11245 DELANO ST",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916064219",
            "telephone_number": "213-709-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N CENTRAL AVE FL 18",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042322",
            "telephone_number": "213-709-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE WITH THE COVENANT OF THE TRINITY ARIZONA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "ZANDRA",
        "authorized_official_title_or_position": "CFO/COO",
        "authorized_official_telephone_number": "213-709-0777"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.arizona.actmedicalgroup.net",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11245 Delano St",
            "city": "North Hollywood",
            "state": "CA",
            "country_code": "US",
            "postal_code": "916064219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ACT Medical Group Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Phoenix, AZ
• Gerontology Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2019; 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.