NPIMap

Organization Active NPI

Agh Laveen LLC

Doing business as Dignity Health Arizona General Hospital Emergency Room

  • Emergency Care Clinic/Center
  • Glendale, AZ
National Provider Identifier
1114466950
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
H6937 Issued in AZ
Legal business name
AGH LAVEEN LLC
Doing business as
Dignity Health Arizona General Hospital Emergency Room
Practice address
8310 W Camelback Rd
Glendale, AZ 85305-3220
Phone
(480) 307-9610
Fax
(480) 307-9614
NPI assigned
Feb 13, 2017
Last updated
May 13, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Authorized official

Name
Jane Hanson
Title
Ceo
Phone
(480) 410-4523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X H6937 AZ Primary

Addresses

Primary practice location

8310 W Camelback Rd
Glendale, AZ 85305-3220

Mailing address

3030 N Central Ave Ste 1402
Phoenix, AZ 85012-2720
Phone (602) 406-3306

Other names 1

  • Dignity Health Arizona General Hospital Emergency Room Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140912001647 AZ Part A Provider - Hospital 4789803370 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glendale, AZ; Goodyear, AZ; Laveen, AZ; Surprise, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114466950. Details of each certification follow.

Hospital certification: CCN 030136

Legal name
AGH LAVEEN LLC
Doing business as
DIGNITY HEALTH ARIZONA GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 30, 2015
Last certification
Oct 9, 2019
Beds
16
Ownership / control type
Private (for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 2014 in AZ
Enrollment address
7171 S 51St Ave
Laveen, AZ 85339-2923
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Mesa, AZ
    • NPI 1053853978

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona Genral Hospital Emergemcy Room

    • Emergency Care Clinic/Center
    • Goodyear, AZ
    • NPI 1083165849

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital

    • General Acute Care Hospital
    • Laveen, AZ
    • NPI 1154748416

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Mesa, AZ
    • NPI 1154872950

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Chandler, AZ
    • NPI 1205378171

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Surprise, AZ
    • NPI 1235680034

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Glendale, AZ
    • NPI 1275084030

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Phoenix, AZ
    • NPI 1447700968

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Chandler, AZ
    • NPI 1508317306

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Phoenix, AZ
    • NPI 1548711302

    O20140912001647

    Same enrollment
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Gilbert, AZ
    • NPI 1750831145

    O20140912001647

    Same enrollment

Care Compare: Hospital

Medicare Care Compare
Listed as
Dignity Health - Arizona General HospitalCCN 030136 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2123890Dignity Health Arizona General Hospital-Camelback8310 W Camelback Rd, Glendale, AZ 85305AccreditationNov 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
East Mesa Medical Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

  • Agh Laveen LLC

    dba Dignity Health Arizona Genral Hospital Emergemcy Room

    • Emergency Care Clinic/Center
    • Goodyear, AZ
    • NPI 1083165849
    NPD tax ID
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital

    • General Acute Care Hospital
    • Laveen, AZ
    • NPI 1154748416
    NPD tax ID
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Surprise, AZ
    • NPI 1235680034
    NPD tax ID
  • Agh Laveen LLC

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Glendale, AZ
    • NPI 1275084030
    NPD tax ID
  • East Mesa Medical Center

    dba Dignity Health Arizona General Hospital Emergency Room

    • Emergency Care Clinic/Center
    • Mesa, AZ
    • NPI 1073064879
    NPD tax ID

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Aaron J Mickelson Individual Corporate OfficerCmo May 1, 2022
W-2 Managing EmployeeCmo May 1, 2022
Agh Phoenix LLC Organization, Phoenix, AZ LLC, Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2014 100%
Eric T Sorensen Individual Corporate DirectorDirector Nov 1, 2021
Jeffrey Thomas O'Malley Individual Corporate DirectorBoard Member Mar 1, 2020
Commonspirit Health Organization, Chicago, IL Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2019 100%
Operational/Managerial Control Feb 1, 2019 100%
Dignity Health Organization, San Francisco, CA Corporation, Non-profit Other Feb 1, 2019
Peggy Sanborn Individual Corporate DirectorBoard Member Aug 22, 2018
Daniel Morissette Individual Corporate OfficerCfo, Commonspirit Health Feb 1, 2019
OtherCfo, Commonspirit Health Sep 1, 2023
Derek Havens Individual Corporate DirectorDirector May 1, 2022
Steven W Scharmann Individual Corporate OfficerVP, Finance and Rev Cycle Feb 1, 2019
John E Petersdorf Individual Corporate OfficerSVP/ Operations Finance Feb 1, 2019
Larissa Spraker Individual Corporate DirectorDirector Nov 1, 2021
John Bauer Individual Corporate OfficerCfo Nov 4, 2019
W-2 Managing EmployeeCfo Nov 4, 2019
Dignity Community Care Organization, San Francisco, CA Created for acquisition, Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2019 100%
Bradley Pristelski Individual Corporate DirectorBoard Member Mar 1, 2020
Jane Hanson Individual Corporate OfficerCeo Jul 30, 2018
W-2 Managing EmployeeCeo Jul 30, 2018

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 123

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 123

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1114466950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 N CENTRAL AVE STE 1402",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122720",
            "telephone_number": "602-406-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8310 W CAMELBACK RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853053220",
            "telephone_number": "480-307-9610",
            "fax_number": "480-307-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGH LAVEEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-410-4523"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "AZ",
            "license": "H6937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dignity Health Arizona General Hospital Emergency Room",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dignity Health Arizona General Hospital Emergency Room",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.