Four Seasons Medical Services LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

FOUR SEASONS MEDICAL SERVICES LLC

Practice address

19820 N 7TH Ave
Suite 230-D
Phoenix, AZ 85027-4736

Phone

(602) 369-8112

NPI assigned

Feb 19, 2016

Last updated

Feb 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gregory Brian Maxon Maldonado

Title

Manager/President

Phone

(602) 369-8112

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1455840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1023477916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 CENTERVILLE RD",
            "address_2": "SUITE 400",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198081660",
            "telephone_number": "602-369-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19820 N 7TH AVE",
            "address_2": "SUITE 230-D",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274736",
            "telephone_number": "602-369-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-19",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "MAXON MALDONADO",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "MANAGER/PRESIDENT",
        "authorized_official_telephone_number": "602-369-8112",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Four Peaks Medical Supply
• Four Seasons Medical Concierge LLC
• Derek Fournier
• Whitney Shae Foust, ACNPC-AG
• Christen Marissa Fouts, FNP-C
• Patricia M Fowl, CRNA
• Richard J Fowl, M.D.

• Specialist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.