NPIMap

Organization Active NPI

The Source Naturopathic Medical Clinic

  • Health Service Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1174905038
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
AZ15-1492 Issued in AZ
Legal business name
THE SOURCE NATUROPATHIC MEDICAL CLINIC
Practice address
550 W Indian School Rd Ste 122
Phoenix, AZ 85013-3200
Phone
(602) 234-1158
Fax
(602) 234-9691
NPI assigned
Jun 26, 2015
Last updated
Jun 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Authorized official

Name
Dr. Maria Helioti, NMDNPI 1295552008
Title
Clinical Physician
Phone
(585) 469-9067

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
Health Service Clinic/Center 261QH0100X AZ15-1492 AZ Primary

Addresses

Primary practice location

550 W Indian School Rd Ste 122
Phoenix, AZ 85013-3200

Mailing address

550 W. Indian School Rd Suite 122
Phoenix, AZ 85013
Phone (602) 234-1158

National Provider Directory

National Provider Directory
Tax ID family
The Source Naturopathic Medical Clinic2 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 8

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": "1435276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1174905038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W. INDIAN SCHOOL RD SUITE 122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85013",
            "telephone_number": "602-234-1158",
            "fax_number": "602-234-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W INDIAN SCHOOL RD STE 122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133200",
            "telephone_number": "602-234-1158",
            "fax_number": "602-234-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SOURCE NATUROPATHIC MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-26",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "HELIOTI",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "CLINICAL PHYSICIAN",
        "authorized_official_telephone_number": "585-469-9067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NMD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AZ",
            "license": "AZ15-1492",
            "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 Jun 26, 2015; 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.