NPIMap

Organization Active NPI

Integra Home Doctors, Inc.

  • General Practice Physician
  • Peoria, AZ
National Provider Identifier
1295131712
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
INTEGRA HOME DOCTORS, INC.
Practice address
16165 N 83Rd Ave
Suite 200
Peoria, AZ 85382-5816
Phone
(623) 888-3014
NPI assigned
Nov 11, 2014
Last updated
May 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Authorized official

Name
Mr. Glenn Leong Manguerra
Title
President
Phone
(773) 791-9340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

16165 N 83Rd Ave
Suite 200
Peoria, AZ 85382-5816

Mailing address

16165 N 83Rd Ave
Suite 200
Peoria, AZ 85382-5816
Phone (623) 888-3014

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463961600000",
    "number": "1295131712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16165 N 83RD AVE",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853825816",
            "telephone_number": "623-888-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16165 N 83RD AVE",
            "address_2": "SUITE 200",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853825816",
            "telephone_number": "623-888-3014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA HOME DOCTORS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-11",
        "last_updated": "2016-05-23",
        "status": "A",
        "authorized_official_last_name": "MANGUERRA",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "LEONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-791-9340",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.