Organization Active NPI

Glendale Medical Partners LLC

Doing business as Camelback Medical Centers

  • Physical Medicine & Rehabilitation Physician
  • Phoenix, AZ
National Provider Identifier
1225593270
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
GLENDALE MEDICAL PARTNERS LLC
Doing business as
Camelback Medical Centers
Practice address
9971 W Camelback Rd Ste 105
Phoenix, AZ 85037-5011
Phone
(480) 306-7227
NPI assigned
Feb 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Cassidy Gaddis
Title
Credentialing Officer
Phone
(480) 306-7227

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

9971 W Camelback Rd Ste 105
Phoenix, AZ 85037-5011

Mailing address

4432 N Miller Rd Ste 102
Scottsdale, AZ 85251-3697
Phone (480) 306-7227

Other names 1

  • Camelback Medical Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250904003575 AZ Part B Supplier - Clinic/Group Practice 0446752968 Receives reassigned benefits from 4 practitioners
Practice locations: Phoenix, AZ
O20250924002471 AZ DME Supplier - Multi-Specialty - Physician 0446752968 Practice locations: Phoenix, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2311975Glendale Medical Partners9971 W Camelback Rd Ste 105, Phoenix, AZ 85037Certificate of waiverOct 1, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1549238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1225593270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4432 N MILLER RD STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513697",
            "telephone_number": "480-306-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9971 W CAMELBACK RD STE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375011",
            "telephone_number": "480-306-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE MEDICAL PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-04",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "GADDIS",
        "authorized_official_first_name": "CASSIDY",
        "authorized_official_title_or_position": "CREDENTIALING OFFICER",
        "authorized_official_telephone_number": "480-306-7227"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camelback Medical Centers",
            "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 Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.