NPIMap

Organization Active NPI

Spectrum Health Center, P.C.

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1215972104
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SPECTRUM HEALTH CENTER, P.C.
Practice address
4136 N 75TH Ave
Ste 101
Phoenix, AZ 85033-3171
Phone
(623) 849-2220
Fax
(623) 849-2574
NPI assigned
Jun 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Authorized official

Name
Billy Joe Evans, M.D.
Title
President
Phone
(602) 849-2220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

4136 N 75TH Ave
Ste 101
Phoenix, AZ 85033-3171

Mailing address

4136 N 75TH Ave
Ste 101
Phoenix, AZ 85033-3171
Phone (623) 849-2220

Other identifiers 1

IdentifierTypeStateIssuer
375272MedicaidAZ

National Provider Directory

National Provider Directory

Locations

4136 N 75th Ave
Ste 101
Phoenix, AZ 85033
Phone (623) 849-2220

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14502/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391472000000",
    "number": "1215972104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4136 N 75TH AVE",
            "address_2": "STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333171",
            "telephone_number": "623-849-2220",
            "fax_number": "623-849-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4136 N 75TH AVE",
            "address_2": "STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333171",
            "telephone_number": "623-849-2220",
            "fax_number": "623-849-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTH CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-02-04",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BILLY",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-849-2220",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375272",
            "state": "AZ"
        }
    ],
    "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 Feb 4, 2014; 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.