Individual provider Active NPI

Emily Caroline Fanning, MD

  • Obstetrics & Gynecology Physician
  • Glendale, AZ
National Provider Identifier
1063902377
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
65939 Issued in AZ
Practice address
6678 W Thunderbird Rd
Glendale, AZ 85306-3721
Phone
(026) 978-1500
Fax
(602) 978-0409
NPI assigned
May 11, 2018
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 65939 AZ Primary

Addresses

Primary practice location

6678 W Thunderbird Rd
Glendale, AZ 85306-3721

Mailing address

6678 W Thunderbird Rd
Glendale, AZ 85306-3721
Phone (026) 978-1500

Other identifiers 1

IdentifierTypeStateIssuer
164270MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715002078 AZ Practitioner - Obstetrics/Gynecology 0941698336 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
65939AZMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obstetrix Medical Group of Phoenix PC CurrentSince Nov 15, 2023 Accepting new patients
Obstetrix Medical Group of Phoenix PC CurrentSince Nov 15, 2023 Accepting new patients
Desert West Obstetrics & Gynecology LTD Obstetrics & Gynecology CurrentSince Sep 1, 2022 Accepting new patients
Honorhealth Past Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

6678 W Thunderbird Rd
Glendale, AZ 85306
Phone (602) 678-1500

1111 E McDowell Rd
#403
Phoenix, AZ 85006
Phone (602) 839-3827

1331 N 7th St
Ste 2
Phoenix, AZ 85006
Phone (602) 257-8118

33400 N 32nd Ave
Phoenix, AZ 85085
Phone (540) 998-0000

33423 N 32nd Ave
Ste 2200
Phoenix, AZ 85085
Phone (480) 398-1550

33423 N 32nd Ave
Ste 3200
Phoenix, AZ 85085
Phone (602) 978-1500

9003 E Shea Blvd
Scottsdale, AZ 85260
Phone (480) 323-3383

9003 E Shea Blvd
Ste 150
Scottsdale, AZ 85260

Interoperability endpoints

  • Direct secure messaging: emily.fanning.p1@direct.dwobgyn.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1063902377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6678 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063721",
            "telephone_number": "026-978-1500",
            "fax_number": "602-978-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6678 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063721",
            "telephone_number": "026-978-1500",
            "fax_number": "602-978-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "EMILY",
        "middle_name": "CAROLINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-11",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "65939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164270",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.