NPIMap

Organization Active NPI

Phoenix Children's Hospital

  • Multi-Specialty Clinic/Center
  • Gilbert, AZ
National Provider Identifier
1376944298
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
SH3107 Issued in AZ
Legal business name
PHOENIX CHILDREN'S HOSPITAL
Practice address
3420 S Mercy Rd
Ste 121
Gilbert, AZ 85297-0419
Phone
(602) 933-6262
NPI assigned
Sep 10, 2014
Last updated
Apr 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Authorized official

Name
Raheel Farough
Title
VP, Managed Care
Phone
(602) 933-3548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X SH3107 AZ Primary

Addresses

Primary practice location

3420 S Mercy Rd
Ste 121
Gilbert, AZ 85297-0419

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-7761
Phone (602) 933-1815

Other identifiers 2

IdentifierTypeStateIssuer
706707MedicaidAZ
876253MedicaidAZ

Other names 1

  • Phoenix Children's Hospital Specialty Clinic Mercy Gilbert Other name

National Provider Directory

National Provider Directory
Tax ID family
GSMC Phoenix Childrens9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1919 E Thomas Rd
Bldg 2108
Phoenix, AZ 85016
Phone (602) 512-8030

NPI Registry JSON

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

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650499200000",
    "number": "1376944298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167761",
            "telephone_number": "602-933-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 S MERCY RD",
            "address_2": "STE 121",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970419",
            "telephone_number": "602-933-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX CHILDREN'S HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A",
        "authorized_official_last_name": "FAROUGH",
        "authorized_official_first_name": "RAHEEL",
        "authorized_official_title_or_position": "VP, MANAGED CARE",
        "authorized_official_telephone_number": "602-933-3548"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "AZ",
            "license": "SH3107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "706707",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876253",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Children's Hospital Specialty Clinic Mercy Gilbert",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Phoenix Children's Hospital Specialty Clinic Mercy Gilbert",
            "code": "5",
            "type": "Other 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 Apr 21, 2022; 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.