NPIMap

Phoenician Medical Center Inc

Organization Active NPI Family Medicine Physician · Phoenix, AZ

NPI 1043090236 · NPPES record last updated Oct 4, 2023

Key facts

NPI
1043090236
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
PHOENICIAN MEDICAL CENTER INC
Practice address
2228 W Northern Ave Ste B202
Phoenix, AZ 85021-9351
Phone
(480) 963-1853
NPI assigned
Oct 4, 2023
Organization subpart
No

Authorized official

Name
Anupam Ahlawat
Title
Coo
Phone
(480) 444-7447

Corporate family (same tax ID) 18

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

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2112200Phoenician Primary Care
2228 W Northern Ave B202, Phoenix, AZ 85021		Certificate of waiverApr 24, 2028

National Provider Directory

Tax ID family
Robert E Bell DO (19 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2084P0800X

Addresses

Primary practice location

2228 W Northern Ave Ste B202
Phoenix, AZ 85021-9351

Mailing address

1343 N Alma School Rd Ste 160
Chandler, AZ 85224-5901
Phone (480) 963-1853

Other names

  • Phoenician Primary Care Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 4, 2023.

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1043090236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 N ALMA SCHOOL RD STE 160",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245901",
            "telephone_number": "480-963-1853",
            "fax_number": "480-963-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 W NORTHERN AVE STE B202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219351",
            "telephone_number": "480-963-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENICIAN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "AHLAWAT",
        "authorized_official_first_name": "ANUPAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "480-444-7447"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenician Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

All providers in Phoenix, AZ · Family Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.