Organization Active NPI

Tom Willim, PA-C PLLC

  • Allergy Physician
  • Chandler, AZ
National Provider Identifier
1043098783
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
TOM WILLIM, PA-C PLLC
Practice address
2425 S Stearman Dr Ste 210
Chandler, AZ 85286-5042
Phone
(480) 999-2559
NPI assigned
Sep 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Thomas Willim, PA-CNPI 1295987923
Title
Owner
Phone
(480) 999-2559

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207KA0200X Primary

Addresses

Primary practice location

2425 S Stearman Dr Ste 210
Chandler, AZ 85286-5042

Mailing address

16122 E Gleneagle Dr
Fountain Hills, AZ 85268-3111
Phone (602) 717-1954

Other practice location 1

16733 E Palisades Blvd Ste 106
Fountain Hills, AZ 85268-8322
Phone (480) 999-2559

Other practice location 2

1780 N State Route 89
Chino Valley, AZ 86323-5695
Phone (480) 999-2559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231204002806 AZ Part B Supplier - Clinic/Group Practice 7618325432 Receives reassigned benefits from 1 practitioner
Practice locations: Chandler, AZ; Chino Valley, AZ; Fountain Hills, AZ

National Provider Directory

National Provider Directory

Locations

2425 S Stearman Dr
Ste 210
Chandler, AZ 85286
Phone (480) 999-2559

16733 E Palisades Blvd
Ste 106
Fountain Hls, AZ 85268
Phone (480) 999-2559

Practitioners & affiliated clinicians

Practitioners 1

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": "1694649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1043098783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16122 E GLENEAGLE DR",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683111",
            "telephone_number": "602-717-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 S STEARMAN DR STE 210",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852865042",
            "telephone_number": "480-999-2559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16733 E Palisades Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Fountain Hills",
            "state": "AZ",
            "postal_code": "852688322",
            "country_code": "US",
            "telephone_number": "480-999-2559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1780 N State Route 89",
            "address_purpose": "LOCATION",
            "city": "Chino Valley",
            "state": "AZ",
            "postal_code": "863235695",
            "country_code": "US",
            "telephone_number": "480-999-2559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TOM WILLIM, PA-C PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "WILLIM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-999-2559",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.