Phoenix Providers

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

NV20151498467 Issued in NV

Legal business name

PHOENIX PROVIDERS

Practice address

3844 Joy LN
Reno, NV 89523

Phone

(775) 722-0574

NPI assigned

Sep 1, 2015

Organization subpart

No

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

Authorized official

Name

Aaron Lee Van Pelt

Title

Ceo

Phone

(775) 722-0574

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1033586417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3844 JOY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89523",
            "telephone_number": "775-722-0574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3844 JOY LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "89523",
            "telephone_number": "775-722-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "VAN PELT",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "775-722-0574"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "NV",
            "license": "NV20151498467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Phillips, CCP
• Revlon Phillips
• Steven Douglas Phillips, MD
• Steven L Phillips, M.D.
• Susan Kelly Phillips, RN
• Jordyan Phoenix
• Wut Yi Phoo
• Philip T Phu, M.D.
• Physical Therapy on the Go LLC (PT on the Go)
• Physical Therapy Partners Nevada LLC

• Preferred Provider Organization in Reno, NV
• Providers in Reno, NV by specialty
• Preferred Provider Organization in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.