John C Lincoln LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OTC 3490 Issued in AZ

Legal business name

JOHN C LINCOLN LLC

Doing business as

Pinnacle Anthem

Practice address

3648 W Anthem Way
Suite A100
Anthem, AZ 85086

Phone

(602) 485-7482

Fax

(623) 434-6448

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Nathan Anspach

Title

Sr. VP

Phone

(623) 434-6200

Specialties & licenses 2

Addresses

Other names 1

• Pinnacle Anthem Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500854400000",
    "number": "1073609848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274171",
            "telephone_number": "623-434-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3648 W ANTHEM WAY",
            "address_2": "SUITE A100",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "85086",
            "telephone_number": "602-485-7482",
            "fax_number": "623-434-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C LINCOLN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2017-07-24",
        "status": "A",
        "authorized_official_last_name": "ANSPACH",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "SR. VP",
        "authorized_official_telephone_number": "623-434-6200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "OTC 3490",
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "AZ",
            "license": "OTC3148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pinnacle Anthem",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chelsea Lynn Jackson
• Rodney Mark Jackson, MD,FAAP
• Sadaf Jamil, DO
• JH Dental
• JL Shaughnessy Dental Associates
• John C. Lincoln, LLC (dba John C. Lincoln Health Quest Family Medicine)
• Tad Johnson-Borowski
• Danielle Lynn Johnson, M.ED
• Joseph Matthew Johnson
• Shauna Jones

• Family Medicine Physician in Anthem, AZ
• Providers in Anthem, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; 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.