Organization Active NPI

Jma Integrated Medicine PLLC

  • Nurse Practitioner
  • Chandler, AZ
National Provider Identifier
1083207096
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
JMA INTEGRATED MEDICINE PLLC
Practice address
2111 E Pecos Rd Ste 1
Chandler, AZ 85225-6072
Phone
(480) 825-0593
NPI assigned
Feb 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Authorized official

Name
Hazem Abawi, PHARM D
Title
Owner
Phone
(480) 313-3600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

2111 E Pecos Rd Ste 1
Chandler, AZ 85225-6072

Mailing address

4637 E Reins Rd
Gilbert, AZ 85297-9515
Phone (480) 313-3600

Other identifiers 1

IdentifierTypeStateIssuer
240004OtherAZNP LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210405000445 AZ Part B Supplier - Clinic/Group Practice 9537576822 Receives reassigned benefits from 1 practitioner
Practice locations: Chandler, AZ; Gilbert, AZ

National Provider Directory

National Provider Directory

Locations

2111 E Pecos Rd
Ste 1
Chandler, AZ 85225
Phone (480) 821-9388

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668729600000",
    "number": "1083207096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4637 E REINS RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979515",
            "telephone_number": "480-313-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 E PECOS RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852256072",
            "telephone_number": "480-825-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMA INTEGRATED MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2022-11-18",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "ABAWI",
        "authorized_official_first_name": "HAZEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-313-3600",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE NUMBER",
            "identifier": "240004",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.