NPIMap

Organization Active NPI

Desert Valley Wellness, PLC

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1174772644
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3259 Issued in AZ
Legal business name
DESERT VALLEY WELLNESS, PLC
Practice address
5310 W Thunderbird Rd
Suite 203
Glendale, AZ 85306-4706
Phone
(602) 548-6500
Fax
(602) 993-0054
NPI assigned
Sep 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Authorized official

Name
Deborah Robertson
Title
Member
Phone
(602) 548-6500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 3259 AZ Primary

Addresses

Primary practice location

5310 W Thunderbird Rd
Suite 203
Glendale, AZ 85306-4706

Mailing address

5310 W Thunderbird Rd
Suite 203
Glendale, AZ 85306-4706
Phone (602) 548-6500

National Provider Directory

National Provider Directory
Tax ID family
Desert Valley Wellness2 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.

NPI Registry JSON

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1174772644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD",
            "address_2": "SUITE 203",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064706",
            "telephone_number": "602-548-6500",
            "fax_number": "602-993-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 W THUNDERBIRD RD",
            "address_2": "SUITE 203",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064706",
            "telephone_number": "602-548-6500",
            "fax_number": "602-993-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT VALLEY WELLNESS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "602-548-6500"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.