Organization Active NPI

Kyrene Medical Center PC

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1043434897
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KYRENE MEDICAL CENTER PC
Practice address
4545 E Chandler Blvd
Suite 201
Phoenix, AZ 85048-7643
Phone
(480) 598-4145
Fax
(480) 598-4346
NPI assigned
Apr 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Authorized official

Name
Mrs. Dorette Oppong-Takyi
Title
Vice President
Phone
(480) 598-4145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4545 E Chandler Blvd
Suite 201
Phoenix, AZ 85048-7643

Mailing address

4545 E Chandler Blvd
Suite 201
Phoenix, AZ 85048-7643
Phone (480) 598-4145

National Provider Directory

National Provider Directory

Locations

124 S Kyrene Rd
Chandler, AZ 85226
Phone (480) 598-4145

1496 S 20th Ave
Safford, AZ 85546
Phone (928) 348-1615

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": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297728000000",
    "number": "1043434897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 E CHANDLER BLVD",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487643",
            "telephone_number": "480-598-4145",
            "fax_number": "480-598-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 E CHANDLER BLVD",
            "address_2": "SUITE 201",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487643",
            "telephone_number": "480-598-4145",
            "fax_number": "480-598-4346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYRENE MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2011-02-15",
        "status": "A",
        "authorized_official_last_name": "OPPONG-TAKYI",
        "authorized_official_first_name": "DORETTE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "480-598-4145",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 15, 2011; 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.