NPIMap

Organization Active NPI

Partners in Recovery, LLC

Doing business as Partners In Recovery Metro Center Integrated Care Clinic

  • Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1184476962
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PARTNERS IN RECOVERY, LLC
Doing business as
Partners In Recovery Metro Center Integrated Care Clinic
Practice address
10217 N Metro Pkwy W
Phoenix, AZ 85051-1438
Phone
(602) 997-9006
Fax
(602) 997-4585
NPI assigned
Apr 3, 2024
Last updated
Aug 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Authorized official

Name
Latrice Shannon Hickman
Title
Chief Risk and Compliance Officer
Phone
(480) 431-9008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

10217 N Metro Pkwy W
Phoenix, AZ 85051-1438

Mailing address

924 N Country Club Dr
Mesa, AZ 85201-4108
Phone (480) 969-3800

Other identifiers 1

IdentifierTypeStateIssuer
OTC13278OtherAZARIZONA DEPARTMENT OF HEALTH SERVICES - LICENSING

Other names 1

  • Partners In Recovery Metro Center Integrated Care Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100203000179 AZ Part B Supplier - Clinic/Group Practice 9638212301 Receives reassigned benefits from 64 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wickenburg, AZ; Phoenix, AZ; Peoria, AZ; Lakeside, AZ; Glendale, AZ; Gilbert, AZ; Mesa, AZ

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Partners in Recovery LLC17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Practitioners & affiliated clinicians

Practitioners 3

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": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723593600000",
    "number": "1184476962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 N COUNTRY CLUB DR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852014108",
            "telephone_number": "480-969-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10217 N METRO PKWY W",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511438",
            "telephone_number": "602-997-9006",
            "fax_number": "602-997-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS IN RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "LATRICE",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "CHIEF RISK AND COMPLIANCE OFFICER",
        "authorized_official_telephone_number": "480-431-9008"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA DEPARTMENT OF HEALTH SERVICES - LICENSING",
            "identifier": "OTC13278",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Partners In Recovery Metro Center Integrated Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 14, 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.