Active NPI
Noahs Ark Family Clinic Corp
- Community/Behavioral Health Agency
- Phoenix, AZ
National Provider Identifier
1093855082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- NOAHS ARK FAMILY CLINIC CORP
- Practice address
- 6707 N 19TH Ave Ste 105
Phoenix, AZ 85015-1105 - Phone
- (480) 247-7691
- Fax
- (480) 919-7040
- NPI assigned
- Feb 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Danny Nguyen, PRESIDENT/CEO
- Title
- President/Ceo
- Phone
- (480) 332-8832
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | |||
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Medical Specialty Clinic/Center | 261QM2500X |
Addresses
Primary practice location
6707 N 19TH Ave Ste 105
Phoenix, AZ 85015-1105
Mailing address
7800 N 55TH Ave Ste 106&107
Glendale, AZ 85301-1321
Phone (623) 931-5001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 337748 | Medicaid | AZ |
Other names 1
- Arizona Care Continuum
National Provider Directory
National Provider DirectoryLocations
7800 N 55th Ave
Ste 106107
Glendale, AZ 85301
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Mental Health Counselor
- Phoenix, AZ
- NPI 1063727857
-
- Professional Counselor
- Glendale, AZ
- NPI 1811547441
-
- Clinical Psychologist
- Milwaukee, WI
- NPI 1447685029
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733788800000",
"number": "1093855082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7800 N 55TH AVE STE 106&107",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853011321",
"telephone_number": "623-931-5001",
"fax_number": "623-931-5120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6707 N 19TH AVE STE 105",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850151105",
"telephone_number": "480-247-7691",
"fax_number": "480-919-7040"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOAHS ARK FAMILY CLINIC CORP",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-07",
"last_updated": "2024-12-10",
"certification_date": "2024-12-10",
"status": "A",
"authorized_official_last_name": "NGUYEN",
"authorized_official_first_name": "DANNY",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "480-332-8832",
"authorized_official_credential": "PRESIDENT/CEO"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "337748",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Arizona Care Continuum",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.