NPIMap

Organization Active NPI

Pophealthcare Medical Services of Az, PC

  • Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1104302413
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
POPHEALTHCARE MEDICAL SERVICES OF AZ, PC
Practice address
51 W 3Rd St Ste 500
Tempe, AZ 85281
Phone
(480) 237-5099
Fax
(877) 358-8109
NPI assigned
Jul 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Authorized official

Name
Susan Porter
Title
Director
Phone
(615) 500-2199

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

51 W 3Rd St Ste 500
Tempe, AZ 85281

Mailing address

113 Seaboard LN Ste 200B
Franklin, TN 37067-8282
Phone (800) 793-7050

Other names 1

  • PopHealthCare Medical Services of AZ, PC - FQ Washington Other name

National Provider Directory

National Provider Directory
Tax ID family
Pophealthcare Medical Services of Az PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723680000000",
    "number": "1104302413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 SEABOARD LN STE 200B",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370678282",
            "telephone_number": "800-793-7050",
            "fax_number": "877-358-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 W 3RD ST STE 500",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85281",
            "telephone_number": "480-237-5099",
            "fax_number": "877-358-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POPHEALTHCARE MEDICAL SERVICES OF AZ, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-500-2199"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PopHealthCare Medical Services of AZ, PC - FQ Washington",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.