District Medical Group, Inc
Organization Active NPI Internal Medicine Physician · Phoenix, AZ
NPI 1295968162 · NPPES record last updated Sep 9, 2009
Key facts
- NPI
- 1295968162
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- DISTRICT MEDICAL GROUP, INC
- Practice address
- 2601 E Roosevelt St
Phoenix, AZ 85008-4973 - Phone
- (602) 344-5011
- NPI assigned
- Aug 26, 2009
- Organization subpart
- No
Authorized official
- Name
- Teresa Cordeiro
- Title
- Credentialing Manager
- Phone
- (602) 470-5000
Other NPIs on the same Medicare enrollment 23
Practitioners 1,142
-
Sara Ashurst, M.D.
-
Nicholas King Baldwin, D.O.
-
Jeffrey E Brichta, D.O.
-
Kevin Chambers, DO
-
Barry Chang, M.D.
-
Kristin Lee Coolidge, FNP-C
-
Karole Marie Davis, M.D.
-
Alexandra Fulleman, PA-C
-
Jill D Gibson, M.D.
-
Robert Kenneth Horsley, M.D.
-
Amanda Horton, NP-C
-
Arpana Jain, MD
-
Richard B Jonas, MD
-
Candice Kaiser, NP-C
-
Babette Witkind Koenig, D.O.
-
Olubukola Komolafe, NURSE PRACTITIONER
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091125000583 | AZ | Part B Supplier - Clinic/Group Practice | 7315086691 |
Receives reassigned benefits from 1,603 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Phoenix, AZ; Prescott, AZ; Scottsdale, AZ; Show Low, AZ; Sierra Vista, AZ; Sun City, AZ; Sun City West, AZ; Tucson, AZ… |
National Provider Directory
Locations
3624 W Anthem Way
Ste C
Anthem, AZ 85086
375 E Elliot Rd
Ste 11
Chandler, AZ 85225
Phone (480) 814-7789
2940 E Banner Gateway Dr
#125
Gilbert, AZ 85234
5515 S Apache Ave
Ste 100
Globe, AZ 85501
Phone (928) 402-8811
5825 E Calle Guadalupe
Guadalupe, AZ 85283
Phone (480) 344-6000
6620 E McKellips Rd
Ste 105
Mesa, AZ 85215
Phone (602) 922-9090
1432 S Dobson Rd
Ste 512
Mesa, AZ 85202
Phone (480) 412-6336
6315 E Main St
Mesa, AZ 85205
Phone (480) 830-4164
14155 N 83rd Ave
Ste 105
Peoria, AZ 85381
Phone (623) 201-8277
5055 E Washington St
Phoenix, AZ 85034
Phone (602) 277-1073
2601 E Roosevelt St
#0D10
Phoenix, AZ 85008
1101 N Central Ave
Ste 200
Phoenix, AZ 85004
Phone (602) 307-5330
9327 N 3rd St
Ste 300
Phoenix, AZ 85020
Phone (602) 631-3166
5650 S 35th Ave
Phoenix, AZ 85041
Phone (602) 655-6400
2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008
1805 N Scottsdale Rd
Tempe, AZ 85288
Phone (480) 877-3000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | |||
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Anatomic Pathology & Clinical Pathology Physician |
207ZP0102X | |||
| Pediatrics Physician |
208000000X | |||
| Psychiatry Physician |
2084P0800X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| Surgery Physician |
208600000X |
Addresses
Primary practice location
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Mailing address
2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000
Other providers in Phoenix, AZ
- District Medical Group, Inc
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- District Medical Group, Inc
- District Medical Group, Inc
- District Medical Group, Inc
- District Medical Group, Inc
- District Medical Group, Inc
- District Medical Group, Inc
- District Medical Group, Inc
All providers in Phoenix, AZ · Internal Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.