Organization Active NPI

Zyon Home Care Physician LLC

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1225816325
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ZYON HOME CARE PHYSICIAN LLC
Practice address
7007 E Main St
Mesa, AZ 85207-8204
Phone
(214) 664-2830
NPI assigned
Sep 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Paidamoyo Wagoneka
Title
Director
Phone
(214) 664-2830

Specialties & licenses 1

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

Addresses

Primary practice location

7007 E Main St
Mesa, AZ 85207-8204

Mailing address

103 Cottonwood St # 824
Morenci, AZ 85540-9634

Other names 1

  • ZYON HOME CARE PHYSICIAN LLC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1225816325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 COTTONWOOD ST # 824",
            "city": "MORENCI",
            "state": "AZ",
            "postal_code": "855409634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852078204",
            "telephone_number": "214-664-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZYON HOME CARE PHYSICIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "WAGONEKA",
        "authorized_official_first_name": "PAIDAMOYO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "214-664-2830"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ZYON HOME CARE PHYSICIAN LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Sep 19, 2023; 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.