Paradise Valley Medical Clinic PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

19362 Issued in AZ

Legal business name

PARADISE VALLEY MEDICAL CLINIC PC

Practice address

9977 N 90TH St
Ste 180
Scottsdale, AZ 85258-4423

Phone

(480) 614-5800

Fax

(480) 614-6322

NPI assigned

Jul 30, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Douglas M Lakin, M.D.NPI 1992783492

Title

Physician

Phone

(480) 614-5800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71487

Practitioners 2

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

• Douglas M. Lakin, M.D.

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1992783492
  Medicare reassignment NPD Authorized official
• Kaitlin Anne Kraemer, PA-C

  • Physician Assistant
  • Scottsdale, AZ
  • NPI 1548507445
  Medicare reassignment

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1326470501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 N 90TH ST",
            "address_2": "STE 180",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584423",
            "telephone_number": "480-614-5800",
            "fax_number": "480-614-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 N 90TH ST",
            "address_2": "STE 180",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584423",
            "telephone_number": "480-614-5800",
            "fax_number": "480-614-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE VALLEY MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LAKIN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-614-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "19362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LISCENSE",
            "identifier": "19362",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paradise Healing Retreat
• Paradise Manor 1, LLC
• Paradise Manor 1,LLC
• Paradise Pediatrics
• Paradise Valley Dental Group PC
• Paradise Valley OB/GYN
• Paradise Valley Surgicare LLC
• Michele Pardon, RN
• Denise Ann Parish, RN
• James M Parish, M.D.

• Internal Medicine Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.