NPIMap

Organization Active NPI

Phoenix Medical Group, Inc.

  • Orthopedic Chiropractor
  • Ontario, CA
National Provider Identifier
1255763058
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
Legal business name
PHOENIX MEDICAL GROUP, INC.
Practice address
4355 E Airport Dr
Suite 100
Ontario, CA 91761-7812
Phone
(909) 937-3400
Fax
(909) 937-3411
NPI assigned
Aug 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Authorized official

Name
Dr. Brent Pratley, MD
Title
Orthopedic
Phone
(951) 687-6600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X

Addresses

Primary practice location

4355 E Airport Dr
Suite 100
Ontario, CA 91761-7812

Mailing address

3576 Arlington Ave
Suite 100
Riverside, CA 92506-3943
Phone (951) 687-6600

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Medical Group Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4355 E Airport Dr
Ste 100
Ontario, CA 91761
Phone (909) 390-0662

NPI Registry JSON

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

{
    "created_epoch": "1375401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375401600000",
    "number": "1255763058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3576 ARLINGTON AVE",
            "address_2": "SUITE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063943",
            "telephone_number": "951-687-6600",
            "fax_number": "951-687-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4355 E AIRPORT DR",
            "address_2": "SUITE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617812",
            "telephone_number": "909-937-3400",
            "fax_number": "909-937-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-02",
        "last_updated": "2013-08-02",
        "status": "A",
        "authorized_official_last_name": "PRATLEY",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "ORTHOPEDIC",
        "authorized_official_telephone_number": "951-687-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.