Mountainside Medical Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MOUNTAINSIDE MEDICAL CLINIC

Practice address

4139 W Bell Rd Ste 8&9
Phoenix, AZ 85053-2753

Phone

(507) 319-7780

NPI assigned

Jun 18, 2019

Organization subpart

No

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

Authorized official

Name

Liban Osman, FNP

Title

Family Nurse Practitioner

Phone

(480) 687-7190

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20430/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588809600000",
    "number": "1346800646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9365",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853740139",
            "telephone_number": "480-687-7190",
            "fax_number": "480-687-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4139 W BELL RD STE 8&9",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850532753",
            "telephone_number": "507-319-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINSIDE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-18",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A",
        "authorized_official_last_name": "OSMAN",
        "authorized_official_first_name": "LIBAN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "480-687-7190",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountainside Fitness Acquisitions, LLC
• Mountainside Fitness Acquisitions, LLC
• Mountainside Fitness Acquisitions, LLC
• Mountainside Fitness Acquisitions, LLC
• Mountainside Fitness Acquisitions, LLC
• Mountainside Wellness Center Inc
• Mountaintop Behavioral Health Services LLC
• Mountzion Home Assisting Live Home
• Rawad Mounzer, M.D.
• Melanie Mourt, ND

• Family Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.