NPIMap

Organization Active NPI

Arizona State University

Doing business as Arizona State University Health Services

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1255511465
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ARIZONA STATE UNIVERSITY
Doing business as
Arizona State University Health Services
Practice address
4701 West Thunderbird Road
University Center Building, Room 190
Glendale, AZ 85306
Phone
(602) 543-8019
Fax
(602) 543-8079
NPI assigned
Nov 6, 2007
Last updated
Nov 3, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ARIZONA STATE UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Authorized official

Name
Dr. Allan Markus, M.D.
Title
Physician/Director
Phone
(480) 965-1145

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Family Nurse Practitioner 363LF0000X AZ Primary
Family Medicine Physician 207Q00000X
Family Medicine Physician 207Q00000X AZ

Addresses

Primary practice location

4701 West Thunderbird Road
University Center Building, Room 190
Glendale, AZ 85306

Mailing address

PO Box 872104
Tempe, AZ 85287-2104
Phone (480) 965-3346

Other names 1

  • Arizona State University Health Services 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
03D0880135Arizona State Univ West Student Health Services4701 West Thunderbird Road Ucb 190, Glendale, AZ 85306Provider-performed microscopySep 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Health Servic13 organizations share this tax ID, including this one
Part of
Community Health Servic

Other organizations with this tax ID 12

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

Locations

4701 W Thunderbird Rd
Rm 190
Glendale, AZ 85306
Phone (602) 543-8019

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1255511465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 872104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852872104",
            "telephone_number": "480-965-3346",
            "fax_number": "480-965-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 WEST THUNDERBIRD ROAD",
            "address_2": "UNIVERSITY CENTER BUILDING, ROOM 190",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85306",
            "telephone_number": "602-543-8019",
            "fax_number": "602-543-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARIZONA STATE UNIVERSITY",
        "enumeration_date": "2007-11-06",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "MARKUS",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_title_or_position": "PHYSICIAN/DIRECTOR",
        "authorized_official_telephone_number": "480-965-1145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona State University Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; 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.