NPIMap

Organization Active NPI

Carelock, LLC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1245795459
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CARELOCK, LLC
Practice address
2920 E Mohawk LN Ste 101
Phoenix, AZ 85050-4773
Phone
(480) 681-3450
Fax
(800) 960-4547
NPI assigned
Feb 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Authorized official

Name
Dr. John S. Gilliam, MDNPI 1003877085
Title
Medical Director
Phone
(928) 772-1673

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Clinical Medical Laboratory 291U00000X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

2920 E Mohawk LN Ste 101
Phoenix, AZ 85050-4773

Mailing address

15029 N Thompson Peak Pkwy # B111-438
Scottsdale, AZ 85260-2217
Phone (480) 681-3450

Other practice location 1

1934 N Hwy 89
Chino Valley, AZ 86323-5643
Phone (928) 667-1968

Other practice location 2

12075 E State Route 69 Ste A
Dewey, AZ 86327-4517
Phone (928) 485-4142

Other practice location 3

14600 S Waterberry St
Mayer, AZ 86333-2027
Phone (928) 271-5490

Other practice location 4

2150 W Indian School Rd
Phoenix, AZ 85015-4907
Phone (480) 681-3450

Other identifiers 2

IdentifierTypeStateIssuer
388615MedicaidAZ
600874MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190430001326 AZ Part B Supplier - Clinic/Group Practice 9436491172 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
Practice locations: Chino Valley, AZ; Dewey, AZ; Mayer, AZ; Phoenix, AZ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

12075 E State Route 69
Dewey, AZ 86327
Phone (928) 404-1488

20175 E Stagecoach Trl
Ste B
Mayer, AZ 86333

14600 S Waterberry St
Unit B
Mayer, AZ 86333

14600 S Waterberry St
Unit A
Mayer, AZ 86333

15029 N Thompson Peak Pkwy
#B111438
Scottsdale, AZ 85260

929 NW 164th St
Ste 109
Edmond, OK 73013
Phone (405) 596-0885

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ABJGBD

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758067200000",
    "number": "1245795459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15029 N THOMPSON PEAK PKWY # B111-438",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602217",
            "telephone_number": "480-681-3450",
            "fax_number": "800-960-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 E MOHAWK LN STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504773",
            "telephone_number": "480-681-3450",
            "fax_number": "800-960-4547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1934 N Hwy 89",
            "address_purpose": "LOCATION",
            "city": "Chino Valley",
            "state": "AZ",
            "postal_code": "863235643",
            "country_code": "US",
            "telephone_number": "928-667-1968",
            "fax_number": "866-205-4076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12075 E State Route 69 Ste A",
            "address_purpose": "LOCATION",
            "city": "Dewey",
            "state": "AZ",
            "postal_code": "863274517",
            "country_code": "US",
            "telephone_number": "928-485-4142",
            "fax_number": "866-205-4076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14600 S Waterberry St",
            "address_purpose": "LOCATION",
            "city": "Mayer",
            "state": "AZ",
            "postal_code": "863332027",
            "country_code": "US",
            "telephone_number": "928-271-5490",
            "fax_number": "866-205-4076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 W Indian School Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850154907",
            "country_code": "US",
            "telephone_number": "480-681-3450",
            "fax_number": "866-205-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARELOCK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-01",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A",
        "authorized_official_last_name": "GILLIAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "928-772-1673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388615",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600874",
            "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 Sep 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.