NPIMap

Organization Active NPI

Phoenician Medical Center Inc

Doing business as Phoenician Primary Care

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1043090236
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHOENICIAN MEDICAL CENTER INC
Doing business as
Phoenician Primary Care
Practice address
2228 W Northern Ave Ste B202
Phoenix, AZ 85021-9351
Phone
(480) 963-1853
NPI assigned
Oct 4, 2023
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Psychiatry PhysicianGroup: 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 1

  • Phoenician Primary 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
03D2112200Phoenician Primary Care2228 W Northern Ave B202, Phoenix, AZ 85021Certificate of waiverApr 24, 2028

National Provider Directory

National Provider Directory
Tax ID family
Phoenician Medical Center19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

2228 W Northern Ave
Ste B202
Phoenix, AZ 85021
Phone (480) 346-9522

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.