Organization Active NPI

Sun Valley Family Practice

  • Family Medicine Physician
  • Avondale, AZ
National Provider Identifier
1265696447
Registry record updated Jan 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUN VALLEY FAMILY PRACTICE
Practice address
12409 West Indian School Road
Building E
Avondale, AZ 85392
Phone
(623) 536-5353
Fax
(623) 935-7790
NPI assigned
Jul 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2012

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

Authorized official

Name
Jojo Hoertig
Title
Operations Manager
Phone
(623) 935-7788

Specialties & licenses 1

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

Addresses

Primary practice location

12409 West Indian School Road
Building E
Avondale, AZ 85392

Mailing address

17215 North 72ND Drive
Suite C-125
Glendale, AZ 85308
Phone (623) 935-7788

National Provider Directory

National Provider Directory

Locations

12409 W Indian School Rd
#B
Avondale, AZ 85392
Phone (623) 536-5353

13020 W Rancho Santa Fe Blvd
Ste 102
Avondale, AZ 85392
Phone (623) 536-0044

17215 N 72nd Dr
Ste C125
Glendale, AZ 85308
Phone (623) 935-7788

17215 N 72nd Dr
#C125
Glendale, AZ 85308

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1216166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327622400000",
    "number": "1265696447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17215 NORTH 72ND DRIVE",
            "address_2": "SUITE C-125",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-935-7788",
            "fax_number": "623-935-7790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12409 WEST INDIAN SCHOOL ROAD",
            "address_2": "BUILDING E",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "85392",
            "telephone_number": "623-536-5353",
            "fax_number": "623-935-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN VALLEY FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-16",
        "last_updated": "2012-01-27",
        "status": "A",
        "authorized_official_last_name": "HOERTIG",
        "authorized_official_first_name": "JOJO",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "623-935-7788"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2012; 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.