Active NPI
Nova Care Multiclinic LLC
- Urgent Care Clinic/Center
- Phoenix, AZ
National Provider Identifier
1174211007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- NOVA CARE MULTICLINIC LLC
- Practice address
- 1717 W Northern Ave Ste 200
Phoenix, AZ 85021-5478 - Phone
- (623) 703-9840
- NPI assigned
- Apr 27, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Viashen Moodley, NONE
- Title
- Administrator
- Phone
- (623) 703-9840
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | |||
| Behavior Technician | 106S00000X | |||
| Case Manager/Care Coordinator | 171M00000X | |||
| Specialist | 174400000X | |||
| Integrative Medicine Physician | 202D00000X | |||
| Family Medicine Physician | 207Q00000X | |||
| Adolescent Medicine (Family Medicine) Physician | 207QA0000X | |||
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | |||
| Adult Medicine Physician | 207QA0505X | |||
| Internal Medicine Physician | 207R00000X | |||
| General Practice Physician | 208D00000X | |||
| Urgent Care Clinic/Center | 261QU0200X | Primary | ||
| Prevention Professional | 405300000X |
Addresses
Primary practice location
1717 W Northern Ave Ste 200
Phoenix, AZ 85021-5478
Mailing address
1717 W Northern Ave Ste 204D
Phoenix, AZ 85021-5471
Phone (623) 703-9840
National Provider Directory
National Provider DirectoryLocations
1717 W Northern Ave
Ste 204D
Phoenix, AZ 85021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682553600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682553600000",
"number": "1174211007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 W NORTHERN AVE STE 204D",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850215471",
"telephone_number": "623-703-9840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 W NORTHERN AVE STE 200",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850215478",
"telephone_number": "623-703-9840"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOVA CARE MULTICLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-04-27",
"last_updated": "2023-04-27",
"certification_date": "2023-04-27",
"status": "A",
"authorized_official_last_name": "MOODLEY",
"authorized_official_first_name": "VIASHEN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "623-703-9840",
"authorized_official_credential": "NONE"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "174400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "202D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Integrative Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QA0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Adolescent Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
},
{
"code": "405300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Prevention Professional",
"state": null,
"license": null,
"primary": false
}
],
"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 Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.