NPIMap

Organization Active NPI

Deseret Family Practice, LTD.

Doing business as Deseret Family Medicine

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
National Provider Identifier
1215960638
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
DESERET FAMILY PRACTICE, LTD.
Doing business as
Deseret Family Medicine
Practice address
1425 S Greenfield Rd
101
Mesa, AZ 85206-5529
Phone
(480) 981-3000
Fax
(480) 654-5761
NPI assigned
Jul 9, 2006
Last updated
Jul 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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

Authorized official

Name
Dr. Robert J Allen, MDNPI 1972538569
Title
President
Phone
(480) 981-3000

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Chiropractor 111N00000X 4101 AZ
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 006034 AZ
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1425 S Greenfield Rd
101
Mesa, AZ 85206-5529

Mailing address

1425 S Greenfield Rd
101
Mesa, AZ 85206-5529
Phone (480) 981-3000

Other names 1

  • Deseret Family Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

6410 S Kings Ranch Rd
Gold Canyon, AZ 85118
Phone (480) 981-3000

1425 S Greenfield Rd
Ste 1
Mesa, AZ 85206

215 S Power Rd
Ste 106
Mesa, AZ 85206
Phone (480) 214-0051

2610 E University Dr
Ste 202
Mesa, AZ 85213
Phone (602) 981-3000

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501459200000",
    "number": "1215960638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S GREENFIELD RD",
            "address_2": "101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065529",
            "telephone_number": "480-981-3000",
            "fax_number": "480-654-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S GREENFIELD RD",
            "address_2": "101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065529",
            "telephone_number": "480-981-3000",
            "fax_number": "480-654-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERET FAMILY PRACTICE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2017-07-31",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-981-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "4101",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "AZ",
            "license": "006034",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deseret Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; 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.