NPIMap

Organization Active NPI

Honorhealth Medical Group, LLC

  • Primary Care Clinic/Center
  • Peoria, AZ
National Provider Identifier
1043851793
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HONORHEALTH MEDICAL GROUP, LLC
Practice address
10230 W Happy Valley Pkwy Ste 200
Peoria, AZ 85383-4255
Phone
(623) 561-3030
Fax
(623) 825-5630
NPI assigned
Oct 3, 2019
Last updated
Sep 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Authorized official

Name
Savas Petrides
Title
SVP/Ceo
Phone
(480) 696-4020

Specialties & licenses 1

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

Addresses

Primary practice location

10230 W Happy Valley Pkwy Ste 200
Peoria, AZ 85383-4255

Mailing address

2500 W Utopia Rd Ste 100
Phoenix, AZ 85027-4172
Phone (480) 587-5314

Other names 1

  • John C. Lincoln, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000717 AZ Part B Supplier - Clinic/Group Practice 1557274057 Receives reassigned benefits from 518 practitioners

National Provider Directory

National Provider Directory
Tax ID family
Deer Valley Family Prac67 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Practitioners & affiliated clinicians

Practitioners 528

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 528

NPI Registry JSON

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1043851793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274172",
            "telephone_number": "480-587-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10230 W HAPPY VALLEY PKWY STE 200",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853834255",
            "telephone_number": "623-561-3030",
            "fax_number": "623-825-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HONORHEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "PETRIDES",
        "authorized_official_first_name": "SAVAS",
        "authorized_official_title_or_position": "SVP/CEO",
        "authorized_official_telephone_number": "480-696-4020"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John C. Lincoln, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.