Agave Physician Services LLC

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

Legal business name

AGAVE PHYSICIAN SERVICES LLC

Practice address

3240 E Union Hills Dr Ste 145
Phoenix, AZ 85050-2652

Phone

(602) 855-3500

Fax

(855) 930-3500

NPI assigned

Sep 27, 2021

Last updated

Sep 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rhett S Andersen

Title

Member

Phone

(801) 420-0077

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1053082263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 N 1100 E",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840622066",
            "telephone_number": "801-420-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 E UNION HILLS DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850502652",
            "telephone_number": "602-855-3500",
            "fax_number": "855-930-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAVE PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "RHETT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "801-420-0077"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hospice and Palliative Medicine (Internal Medicine) Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.