NPIMap

Organization Active NPI

Phoenician Medical Center, Inc

  • Family Medicine Physician
  • Peoria, AZ
National Provider Identifier
1255110474
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHOENICIAN MEDICAL CENTER, INC
Practice address
13943 N 91St Ave BLDG E
Peoria, AZ 85381-3629
Phone
(480) 963-1953
Fax
(480) 963-1854
NPI assigned
Sep 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Anupam Ahlawat
Title
Coo
Phone
(480) 444-7447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

13943 N 91St Ave BLDG E
Peoria, AZ 85381-3629

Mailing address

1343 N Alma School Rd Ste 160
Chandler, AZ 85224-5901
Phone (480) 963-1853

Other names 1

  • Phoenician Primary Care Doing business as

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
03D1105256Phoenician Primary Care13943 N 91St Ave BLDG E, Peoria, AZ 85381Certificate of waiverSep 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Robert E Bell DO19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

13943 N 91st Ave
Bldg E
Peoria, AZ 85381
Phone (623) 972-6019

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1255110474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 N ALMA SCHOOL RD STE 160",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245901",
            "telephone_number": "480-963-1853",
            "fax_number": "480-963-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13943 N 91ST AVE BLDG E",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813629",
            "telephone_number": "480-963-1953",
            "fax_number": "480-963-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENICIAN MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "AHLAWAT",
        "authorized_official_first_name": "ANUPAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "480-444-7447"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenician Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.