NPIMap

Organization Active NPI

Breast Care, P.C.

  • Preferred Provider Organization
  • Phoenix, AZ
National Provider Identifier
1245396811
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
19443 Issued in AZ
Legal business name
BREAST CARE, P.C.
Practice address
16620 N 40TH St
Ste. H - 3
Phoenix, AZ 85032-3348
Phone
(602) 971-5002
Fax
(602) 368-4638
NPI assigned
Dec 28, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Christi Sue Bourne, M.D.NPI 1356387518
Title
Owner
Phone
(602) 971-5002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 19443 AZ Primary

Addresses

Primary practice location

16620 N 40TH St
Ste. H - 3
Phoenix, AZ 85032-3348

Mailing address

16620 N 40TH St
Ste. H - 3
Phoenix, AZ 85032-3348
Phone (602) 971-5002

Other identifiers 1

IdentifierTypeStateIssuer
295437MedicaidAZ

National Provider Directory

National Provider Directory

Locations

16620 N 40th St
Ste H3
Phoenix, AZ 85032
Phone (602) 971-5002

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245396811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST",
            "address_2": "STE. H - 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323348",
            "telephone_number": "602-971-5002",
            "fax_number": "602-368-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST",
            "address_2": "STE. H - 3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323348",
            "telephone_number": "602-971-5002",
            "fax_number": "602-368-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAST CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOURNE",
        "authorized_official_first_name": "CHRISTI",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-971-5002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "AZ",
            "license": "19443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295437",
            "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 Aug 22, 2020; 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.