NPIMap

Organization Active NPI

Higley Family Medicine, LLC

  • Family Medicine Physician
  • Gilbert, AZ
National Provider Identifier
1366626400
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2399 Issued in AZ
Legal business name
HIGLEY FAMILY MEDICINE, LLC
Practice address
1425 S Higley Rd
Suite 102
Gilbert, AZ 85296-4798
Phone
(480) 988-6878
Fax
(480) 988-6879
NPI assigned
Dec 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Trevor W Whitmore, P.A.
Title
Owner/Physician Assistant
Phone
(480) 988-6878

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 2399 AZ Primary

Addresses

Primary practice location

1425 S Higley Rd
Suite 102
Gilbert, AZ 85296-4798

Mailing address

1425 S Higley Rd
Suite 102
Gilbert, AZ 85296-4798
Phone (480) 988-6878

Other identifiers 3

IdentifierTypeStateIssuer
560674MedicaidAZ
228810MedicaidAZ
286791MedicaidAZ

Other names 1

  • Oliveview Homefront Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1366626400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S HIGLEY RD",
            "address_2": "SUITE 102",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964798",
            "telephone_number": "480-988-6878",
            "fax_number": "480-988-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S HIGLEY RD",
            "address_2": "SUITE 102",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964798",
            "telephone_number": "480-988-6878",
            "fax_number": "480-988-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGLEY FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "WHITMORE",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "480-988-6878",
        "authorized_official_credential": "P.A."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560674",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228810",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286791",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oliveview Homefront",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.