PHX Mymed Health Access Solutions

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PHX MYMED HEALTH ACCESS SOLUTIONS

Practice address

5777 N. Post Road
Indianapolis, IN 46216-2007

Phone

(317) 354-1187

Fax

(317) 354-1369

NPI assigned

Nov 27, 2019

Last updated

Nov 27, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. C David Smith

Title

Chief Operations Officer

Phone

(317) 354-1187

Specialties & licenses 3

Addresses

Other names 1

• Phoenix Health Data Former legal business name

Locations

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1093351884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 N. POST ROAD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462162007",
            "telephone_number": "317-354-1187",
            "fax_number": "317-354-1369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 N. POST ROAD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462162007",
            "telephone_number": "317-354-1187",
            "fax_number": "317-354-1369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHX MYMED HEALTH ACCESS SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "C",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "317-354-1187",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Health Data",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.