NPIMap

Organization Active NPI

Az Family Medicine PLLC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1104082650
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
40787 Issued in AZ
Legal business name
AZ FAMILY MEDICINE PLLC
Practice address
2601 N 3Rd St Ste 308
Phoenix, AZ 85004-1101
Phone
(602) 264-5359
NPI assigned
Aug 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Dr. Edward Jack Sayegh, M.D
Title
M.D
Phone
(602) 264-5359

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 40787 AZ Primary

Addresses

Primary practice location

2601 N 3Rd St Ste 308
Phoenix, AZ 85004-1101

Mailing address

2601 N 3Rd St Ste 308
Phoenix, AZ 85004-1101
Phone (602) 264-5359

Other identifiers 1

IdentifierTypeStateIssuer
Z125325OtherAZMEDICARE PTAN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1104082650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 N 3RD ST STE 308",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041101",
            "telephone_number": "602-264-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 N 3RD ST STE 308",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041101",
            "telephone_number": "602-264-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "SAYEGH",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "JACK",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "602-264-5359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "40787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z125325",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Oct 13, 2011; 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.