NPIMap

Organization Active NPI

Landmark Medical of Tennessee PC

  • General Practice Physician
  • Scottsdale, AZ
National Provider Identifier
1144944398
Registry record updated Jan 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
LANDMARK MEDICAL OF TENNESSEE PC
Practice address
15333 N Pima Rd Ste 305
Scottsdale, AZ 85260-2717
Phone
(657) 400-5180
NPI assigned
Sep 30, 2022
Last updated
Jan 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2024

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

Authorized official

Name
Christopher Dennis, MDNPI 1811068349
Title
Chief Medical Officer
Phone
(657) 400-5180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

15333 N Pima Rd Ste 305
Scottsdale, AZ 85260-2717

Mailing address

7755 Center Ave Ste 630
Huntington Beach, CA 92647-9152

Other names 1

  • Arizona Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221213002913 AZ Part B Supplier - Clinic/Group Practice 8527453851 Receives reassigned benefits from 3 practitioners
Practice locations: Scottsdale, AZ

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1664496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1144944398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7755 CENTER AVE STE 630",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926479152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15333 N PIMA RD STE 305",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602717",
            "telephone_number": "657-400-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDMARK MEDICAL OF TENNESSEE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "DENNIS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "657-400-5180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Arizona",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.