NPIMap

Organization Active NPI

Sunny View Medical Center, PLLC

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1053684498
Registry record updated Feb 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AZ5729 Issued in AZ
Legal business name
SUNNY VIEW MEDICAL CENTER, PLLC
Practice address
4400 N 32ND St
Suite 110
Phoenix, AZ 85018-3953
Phone
(602) 956-9595
Fax
(602) 956-3232
NPI assigned
Feb 15, 2012
Organization subpart
Yes
Parent organization
SUNNY VIEW MEDICAL CENTER, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 15, 2012

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

Authorized official

Name
Samuel Terry Clark, M.D.NPI 1073506036
Title
Owner/Physician
Phone
(602) 956-9595

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
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X AZ5729 AZ Primary

Addresses

Primary practice location

4400 N 32ND St
Suite 110
Phoenix, AZ 85018-3953

Mailing address

4400 N 32ND St
Suite 110
Phoenix, AZ 85018-3953
Phone (602) 956-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041122000667 AZ Part B Supplier - Clinic/Group Practice 7810952686 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Sunny View Medical Center PLLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

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": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1053684498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 N 32ND ST",
            "address_2": "SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183953",
            "telephone_number": "602-956-9595",
            "fax_number": "602-956-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N 32ND ST",
            "address_2": "SUITE 110",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183953",
            "telephone_number": "602-956-9595",
            "fax_number": "602-956-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNY VIEW MEDICAL CENTER, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUNNY VIEW MEDICAL CENTER, PLLC",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "TERRY",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "602-956-9595",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "AZ5729",
            "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, 2012; 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.