NPIMap

Organization Active NPI

Advanced Internal Medicine, PC

  • Internal Medicine Physician
  • Chandler, AZ
National Provider Identifier
1275722597
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26920 Issued in AZ
Legal business name
ADVANCED INTERNAL MEDICINE, PC
Practice address
1900 W Frye Rd
Suite 3
Chandler, AZ 85224-6235
Phone
(480) 786-9084
Fax
(480) 786-9086
NPI assigned
Oct 23, 2007
Last updated
Jul 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Authorized official

Name
Pina P Shah, M.D.
Title
President
Phone
(480) 786-9084

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26920 AZ Primary

Addresses

Primary practice location

1900 W Frye Rd
Suite 3
Chandler, AZ 85224-6235

Mailing address

1900 W Frye Rd
Suite 3
Chandler, AZ 85224-6235
Phone (480) 786-9084

Other identifiers 1

IdentifierTypeStateIssuer
515059MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311292800000",
    "number": "1275722597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W FRYE RD",
            "address_2": "SUITE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246235",
            "telephone_number": "480-786-9084",
            "fax_number": "480-786-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 W FRYE RD",
            "address_2": "SUITE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246235",
            "telephone_number": "480-786-9084",
            "fax_number": "480-786-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTERNAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2011-07-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "PINA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-786-9084",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "26920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "515059",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.