NPIMap

Organization Active NPI

Arizona State University

  • Community Health Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1265798664
Registry record updated Apr 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
AP4432 Issued in AZ
Legal business name
ARIZONA STATE UNIVERSITY
Practice address
500 N 3Rd St
Phoenix, AZ 85004-2135
Phone
(602) 496-0721
NPI assigned
Apr 10, 2012
Last updated
Apr 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2012

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

Authorized official

Name
Mr. Samuel Younger, MHA FACHE
Title
Manager NP Healthcare
Phone
(602) 496-0721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X AP4432 AZ Primary

Addresses

Primary practice location

500 N 3Rd St
Phoenix, AZ 85004-2135

Mailing address

500 N 3Rd St
Phoenix, AZ 85004-2135
Phone (602) 496-0721

National Provider Directory

National Provider Directory
Tax ID family
Infant Child Research Program13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334016000000",
    "number": "1265798664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042135",
            "telephone_number": "602-496-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042135",
            "telephone_number": "602-496-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-10",
        "last_updated": "2012-04-10",
        "status": "A",
        "authorized_official_last_name": "YOUNGER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "MANAGER NP HEALTHCARE",
        "authorized_official_telephone_number": "602-496-0721",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHA  FACHE"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "AZ",
            "license": "AP4432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.