NPIMap

Organization Active NPI

Ultimate Integrated Patient Care PLLC

  • Custodial Care Facility
  • Peoria, AZ
National Provider Identifier
1134491210
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
005286 Issued in AZ
Legal business name
ULTIMATE INTEGRATED PATIENT CARE PLLC
Practice address
13714 N Plaza del Rio Blvd
Peoria, AZ 85381-4874
Phone
(480) 718-5986
Fax
(480) 664-6813
NPI assigned
Feb 3, 2012
Last updated
Feb 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Authorized official

Name
Valarie C. Loman, DO
Title
Physician
Phone
(480) 718-5986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X 005286 AZ Primary

Addresses

Primary practice location

13714 N Plaza del Rio Blvd
Peoria, AZ 85381-4874

Mailing address

PO Box 10214
Glendale, AZ 85318-0214
Phone (480) 718-5986

Other identifiers 1

IdentifierTypeStateIssuer
456982MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Ultimate Integrated Patient Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328227200000",
    "number": "1134491210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10214",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853180214",
            "telephone_number": "480-718-5986",
            "fax_number": "480-664-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13714 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814874",
            "telephone_number": "480-718-5986",
            "fax_number": "480-664-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE INTEGRATED PATIENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A",
        "authorized_official_last_name": "LOMAN",
        "authorized_official_first_name": "VALARIE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-718-5986",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "AZ",
            "license": "005286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "456982",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.