NPIMap

Organization Active NPI

Honorhealth Medical Group, LLC

Doing business as John C. Lincoln Family Medicine and Wellness Center

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1063795367
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HONORHEALTH MEDICAL GROUP, LLC
Doing business as
John C. Lincoln Family Medicine and Wellness Center
John C. Lincoln, LLC
Practice address
6320 W Union Hills Dr
Ste. 2300B
Glendale, AZ 85308-1096
Phone
(623) 561-9113
Fax
(623) 561-6148
NPI assigned
Sep 22, 2011
Last updated
Oct 2, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6320 W Union Hills Dr
Ste. 2300B
Glendale, AZ 85308-1096

Mailing address

2500 W Utopia Rd
Ste. 100
Phoenix, AZ 85027-4171
Phone (480) 587-5314

Other names 2

  • John C. Lincoln Family Medicine and Wellness Center Doing business as
  • John C. Lincoln, LLC Doing business as

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
This NPI is an additional NPI on the enrollment

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 14

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

View all 14

Locations

6320 W Union Hills Dr
Ste 2300
Glendale, AZ 85308
Phone (623) 561-9113

Practitioners & affiliated clinicians

Practitioners 8

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": "1316649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1063795367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD",
            "address_2": "STE. 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274171",
            "telephone_number": "480-587-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR",
            "address_2": "STE. 2300B",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081096",
            "telephone_number": "623-561-9113",
            "fax_number": "623-561-6148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HONORHEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-22",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John C. Lincoln Family Medicine and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "John C. Lincoln, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.