NPIMap

Organization Active NPI

Arizona Clinic of Gastroenterology PC

  • Gastroenterology Physician
  • Glendale, AZ
National Provider Identifier
1356570378
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
31649 Issued in AZ
Legal business name
ARIZONA CLINIC OF GASTROENTEROLOGY PC
Practice address
13934 N 59TH Ave
Suite 160
Glendale, AZ 85306-4167
Phone
(877) 283-4714
Fax
(623) 444-5495
NPI assigned
Jul 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

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

Authorized official

Name
Sheila R Peirson, CPC
Title
Billing Manager
Phone
(877) 283-4714

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 31649 AZ Primary

Addresses

Primary practice location

13934 N 59TH Ave
Suite 160
Glendale, AZ 85306-4167

Mailing address

PO Box 5819
Peoria, AZ 85385-5819
Phone (877) 283-4714

Other identifiers 1

IdentifierTypeStateIssuer
469524MedicaidAZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1247356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270771200000",
    "number": "1356570378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5819",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853855819",
            "telephone_number": "877-283-4714",
            "fax_number": "623-444-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13934 N 59TH AVE",
            "address_2": "SUITE 160",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064167",
            "telephone_number": "877-283-4714",
            "fax_number": "623-444-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA CLINIC OF GASTROENTEROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-12",
        "last_updated": "2010-04-09",
        "status": "A",
        "authorized_official_last_name": "PEIRSON",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "877-283-4714",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "31649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469524",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2010; 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.