Patricia a Dietzgen DO LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PATRICIA A DIETZGEN DO LLC

Practice address

16515 S 40TH St
Suite 103
Phoenix, AZ 85048-0558

Phone

(480) 961-0760

Fax

(480) 961-0761

NPI assigned

Oct 12, 2007

Last updated

Jan 19, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia A Dietzgen, DO

Title

Owner

Phone

(480) 961-0760

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/2127/brand/1/csg/1/fhir/r4

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.

• Elizabeth A. Carson, DO

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1558405209
  NPD (past)
• Daniela P English, D.O. LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1720004989
  NPD (past)

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295395200000",
    "number": "1255529491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST",
            "address_2": "SUITE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480558",
            "telephone_number": "480-961-0760",
            "fax_number": "480-961-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST",
            "address_2": "SUITE 103",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480558",
            "telephone_number": "480-961-0760",
            "fax_number": "480-961-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA A DIETZGEN DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2011-01-19",
        "status": "A",
        "authorized_official_last_name": "DIETZGEN",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-961-0760",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETO GBA",
            "identifier": "DE7249",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avinash Shivaputrappa Patil, MD
• Chetan Shyam Patil, DDS
• Saurabh Patil
• John Patinella, PHARMD
• Breanna Patino
• Patricia Davis
• Patricia Dianne Johnson, PH.D., P.C.
• Patricia E. Thorpe, MD, PC
• Patricia R Reiff,M.D.,P.C.
• Patrick Kelledy MD PC

• Primary Care Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2011; 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.