NPIMap

Organization Active NPI

Athena Medical Group

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1164918124
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ATHENA MEDICAL GROUP
Practice address
16515 S 40TH St Ste 143
Phoenix, AZ 85048-0560
Phone
(480) 712-8319
Fax
(480) 712-1305
NPI assigned
Jul 2, 2018
Last updated
Jan 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Authorized official

Name
Yancey Scott Gaither, CEO
Title
Managing Partner
Phone
(480) 712-8319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

16515 S 40TH St Ste 143
Phoenix, AZ 85048-0560

Mailing address

16515 S 40TH St Ste 143
Phoenix, AZ 85048-0560
Phone (480) 712-8319

Other practice location 1

800 5th Avenue, Ste 101-800
Seattle, WA 98104
Phone (480) 712-8319

Other practice location 2

7901 4th St N Ste 300
Saint Petersburg, FL 33702-4399
Phone (480) 712-8319

Other practice location 3

401 Ryland St, Suite 200-A
Reno, NV 89502
Phone (480) 712-8319

Other practice location 4

5900 Balcones Drive Suite 6954
Austin, TX 78731
Phone (480) 712-8319

Other practice location 5

1942 Broadway St, Suite 314C
Boulder, CO 80302
Phone (480) 712-8319

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, FL, WA, TX, OR, AL7 enrollments

Enrollment records 7

Enrollment IDStateProvider typePAC IDDetails
O20180829003049 AZ Part B Supplier - Clinic/Group Practice 8921358706 Receives reassigned benefits from 26 practitioners
Practice locations: Chandler, AZ
O20220804001039 AZ DME Supplier - Nurse Practitioner 8921358706 Practice locations: Phoenix, AZ
O20220830001955 FL Part B Supplier - Clinic/Group Practice 8921358706 Receives reassigned benefits from 13 practitioners
Practice locations: Saint Petersburg, FL
O20221005001782 WA Part B Supplier - Clinic/Group Practice 8921358706 Receives reassigned benefits from 17 practitioners
Practice locations: Normandy Park, WA
O20221010000237 TX Part B Supplier - Clinic/Group Practice 8921358706 Receives reassigned benefits from 14 practitioners
Practice locations: Austin, TX
O20240725002472 OR Part B Supplier - Clinic/Group Practice 8921358706 Receives reassigned benefits from 7 practitioners
Practice locations: Salem, OR
O20250702002119 AL Part B Supplier - Clinic/Group Practice 8921358706 Receives reassigned benefits from 1 practitioner
Practice locations: Brewton, AL

National Provider Directory

National Provider Directory

Locations

4913 S Alma School Rd
Ste 1
Chandler, AZ 85248

16515 S 40th St
Phoenix, AZ 85048
Phone (480) 272-8450

5900 Balcones Dr
Ste 6954
Austin, TX 78731

Practitioners & affiliated clinicians

Practitioners 68

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.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768867200000",
    "number": "1164918124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST STE 143",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480560",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST STE 143",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480560",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 5th Avenue, Ste 101-800",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98104",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7901 4th St N Ste 300",
            "address_purpose": "LOCATION",
            "city": "Saint Petersburg",
            "state": "FL",
            "postal_code": "337024399",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Ryland St, Suite 200-A",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "89502",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 Balcones Drive Suite 6954",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78731",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1942 Broadway St, Suite 314C",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "80302",
            "country_code": "US",
            "telephone_number": "480-712-8319",
            "fax_number": "480-712-1305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ATHENA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-02",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A",
        "authorized_official_last_name": "GAITHER",
        "authorized_official_first_name": "YANCEY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "480-712-8319",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.