Peoria Physician Group

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PEORIA PHYSICIAN GROUP

Practice address

13760 N 93Rd Ave Ste 105
Peoria, AZ 85381-4260

Phone

(480) 809-6589

NPI assigned

May 6, 2020

Organization subpart

No

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

Authorized official

Name

Jeremiah Faber

Title

Ceo

Phone

(480) 258-3635

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588723200000",
    "number": "1124649637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 964",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852990964",
            "telephone_number": "480-366-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13760 N 93RD AVE STE 105",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814260",
            "telephone_number": "480-809-6589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEORIA PHYSICIAN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-06",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A",
        "authorized_official_last_name": "FABER",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-258-3635"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peoria Healthcare LLC
• Peoria Healthy Smiles LLC
• Peoria Mind and Wellness PLLC
• Peoria Oral & Implant Surgery PLLC
• Peoria Pain Physicians
• Peoria Stadium Creek ASC LLC
• Peoria Urgent Care and Walk in Clinic PLLC
• Peoria Urgent Care Center, LLC
• Peoria Urgent Care Center,LLC
• Peoria Vista Care LLC

• General Practice Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2020; 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.