NPIMap

Organization Active NPI

The Source Naturopathic Medical Clinic

  • Clinic/Center
  • Mesa, AZ
National Provider Identifier
1053798793
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
15-1487 Issued in AZ
Legal business name
THE SOURCE NATUROPATHIC MEDICAL CLINIC
Practice address
1932 N Mesa Dr Unit 9
Mesa, AZ 85201-1622
Phone
(707) 540-1456
NPI assigned
May 1, 2015
Last updated
May 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2015

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

Authorized official

Name
Dr. David Arneson, NMDNPI 1205034386
Title
Owner
Phone
(602) 234-1158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 15-1487 AZ Primary

Addresses

Primary practice location

1932 N Mesa Dr Unit 9
Mesa, AZ 85201-1622

Mailing address

1932 N Mesa Dr Unit 9
Mesa, AZ 85201-1622
Phone (707) 540-1456

National Provider Directory

National Provider Directory
Tax ID family
The Source Naturopathic Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1053798793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 N MESA DR UNIT 9",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852011622",
            "telephone_number": "707-540-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 N MESA DR UNIT 9",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852011622",
            "telephone_number": "707-540-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SOURCE NATUROPATHIC MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "ARNESON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-234-1158",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NMD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "15-1487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.