NPIMap

Organization Active NPI

District Medical Group Inc

  • Psychiatry Physician
  • Mesa, AZ
National Provider Identifier
1124299334
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
DISTRICT MEDICAL GROUP INC
Practice address
840 E McKellips Rd
Suite #110
Mesa, AZ 85203-9645
Phone
(602) 470-5520
Fax
(480) 649-0783
NPI assigned
Mar 14, 2008
Organization subpart
Yes
Parent organization
DISTRICT MEDICAL GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Authorized official

Name
Teresa Cordeiro
Title
Credentialing Director
Phone
(602) 470-5000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X

Addresses

Primary practice location

840 E McKellips Rd
Suite #110
Mesa, AZ 85203-9645

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other names 1

  • Desert Horizon Psychiatric Services Other name

National Provider Directory

National Provider Directory
Tax ID family
District Medical Group Inc31 organizations share this tax ID, including this one
Part of
District Medical Group Inc

Other organizations with this tax ID 30

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

View all 30

Locations

840 E McKellips Rd
Ste 110
Mesa, AZ 85203
Phone (602) 470-5520

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1124299334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000",
            "fax_number": "602-470-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E MCKELLIPS RD",
            "address_2": "SUITE #110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852039645",
            "telephone_number": "602-470-5520",
            "fax_number": "480-649-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTRICT MEDICAL GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DISTRICT MEDICAL GROUP INC",
        "enumeration_date": "2008-03-14",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "CORDEIRO",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "CREDENTIALING DIRECTOR",
        "authorized_official_telephone_number": "602-470-5000"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Horizon Psychiatric Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; 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.