Healthcare Campus LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEALTHCARE CAMPUS LLC

Practice address

4838 E Baseline Rd Ste 110
Mesa, AZ 85206-4674

Phone

(480) 969-4040

Fax

(480) 295-3722

NPI assigned

Sep 20, 2020

Last updated

Oct 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leslie Kay Felix

Title

Credentialing

Phone

(928) 961-3921

Specialties & licenses 15

Addresses

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

{
    "created_epoch": "1600560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602374400000",
    "number": "1205442704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4838 E BASELINE RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064674",
            "telephone_number": "480-969-4040",
            "fax_number": "480-295-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4838 E BASELINE RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064674",
            "telephone_number": "480-969-4040",
            "fax_number": "480-295-3722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4824 E Baseline Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852064680",
            "country_code": "US",
            "telephone_number": "480-969-4040",
            "fax_number": "480-295-3722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTHCARE CAMPUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-20",
        "last_updated": "2020-10-11",
        "certification_date": "2020-10-11",
        "status": "A",
        "authorized_official_last_name": "FELIX",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "928-961-3921"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "173F00000X",
            "taxonomy_group": "",
            "desc": "Sleep Specialist, PhD",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2020; 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.