NPIMap

Organization Active NPI

Glendale Pediatrics LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1043074610
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GLENDALE PEDIATRICS LLC
Practice address
2929 N 75TH Ave Ste 5&6
Phoenix, AZ 85033-5400
Phone
(623) 873-1200
Fax
(623) 847-5304
NPI assigned
Feb 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Enrique Sion LopezNPI 1578572087
Title
Physician
Phone
(623) 847-5300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2929 N 75TH Ave Ste 5&6
Phoenix, AZ 85033-5400

Mailing address

6745 N 51St Dr
Glendale, AZ 85301-3425
Phone (623) 847-5300

Other names 1

  • Glendale Pediatrics & Family Care Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1105938Glendale Pediatrics, LLC2929 N 75TH Ave, Suite 5 & 6, Phoenix, AZ 85033Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Glendale Pediatrics Family Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2929 N 75th Ave
Ste 56
Phoenix, AZ 85033
Phone (623) 873-1200

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1043074610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6745 N 51ST DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853013425",
            "telephone_number": "623-847-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 N 75TH AVE STE 5&6",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850335400",
            "telephone_number": "623-873-1200",
            "fax_number": "623-847-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_middle_name": "SION",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "623-847-5300"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glendale Pediatrics & Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.