Phoenix Systems LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHOENIX SYSTEMS LLC

Practice address

1450 S Sandhill Dr
Washington, UT 84780-8129

Phone

(435) 673-0777

NPI assigned

Aug 18, 2025

Organization subpart

No

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

Authorized official

Name

Jon Adam Petty, MANAGING MEMBER

Title

Managing Member

Phone

(435) 691-0629

Specialties & licenses 1

Addresses

Other names 1

• Phoenix Systems Doing business as

Locations

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1205713625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S SANDHILL DR",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847808129",
            "telephone_number": "435-673-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 S SANDHILL DR",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847808129",
            "telephone_number": "435-673-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX SYSTEMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "PETTY",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "435-691-0629",
        "authorized_official_credential": "MANAGING MEMBER"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Systems",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenzi Owen
• Diego Benito Pacrem
• Trevor Dorian Page, D.O.
• Abby Peterson
• Sierra Claudia Peterson, APRN
• Stephen Pitts, MA
• Desiree L Porter, LPC
• Glen Porter, CMHC
• Kristin Porter, PHARM.D.
• Tracey Kathleen Porter, LCSW

• Durable Medical Equipment & Medical Supplies in Washington, UT
• Providers in Washington, UT by specialty
• Durable Medical Equipment & Medical Supplies in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; 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.