MKRP Industries Incorporation

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

33546 Issued in AZ

Legal business name

MKRP INDUSTRIES INCORPORATION

Doing business as

CANYON FAMILY PHYSICIANS

Practice address

2451 E Baseline Rd
Suite 130
Gilbert, AZ 85234-2471

Phone

(480) 507-2213

Fax

(480) 507-0677

NPI assigned

Sep 20, 2005

Organization subpart

No

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

Authorized official

Name

Dennis Pickering

Title

Owner

Phone

(602) 889-7550

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• CANYON FAMILY PHYSICIANS Doing business as

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1235125840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 E BASELINE RD",
            "address_2": "SUITE 130",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342471",
            "telephone_number": "480-507-2213",
            "fax_number": "480-507-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 E BASELINE RD",
            "address_2": "SUITE 130",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342471",
            "telephone_number": "480-507-2213",
            "fax_number": "480-507-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MKRP INDUSTRIES INCORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "PICKERING",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-889-7550"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "AZ",
            "license": "33546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2Z2444",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "916562",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CANYON FAMILY PHYSICIANS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Maintenance Organization in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Health Maintenance Organization in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.