NPIMap

Organization Active NPI

Ucxtra Umbrella, LLC

Doing business as Urgent Care Extra AZ

  • Urgent Care Clinic/Center
  • Mesa, AZ
National Provider Identifier
1386028421
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
UCXTRA UMBRELLA, LLC
Doing business as
Urgent Care Extra AZ
Practice address
1250 S Clearview Ave
Suite 100
Mesa, AZ 85209
Phone
(480) 988-9108
NPI assigned
Jul 18, 2015
Last updated
Jul 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Authorized official

Name
Amy Panduro
Title
Chief Admin Officer
Phone
(480) 663-2432

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

1250 S Clearview Ave
Suite 100
Mesa, AZ 85209

Mailing address

35945 N Gary Rd
San Tan Valley, AZ 85143

Other identifiers 1

IdentifierTypeStateIssuer
412931MedicaidAZ

Other names 1

  • Urgent Care Extra AZ Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Valley Urgent Carellc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

35945 N Gary Rd
San Tan Valley, AZ 85143
Phone (480) 827-5750

NPI Registry JSON

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

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1386028421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35945 N GARY RD",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "85143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S CLEARVIEW AVE",
            "address_2": "SUITE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85209",
            "telephone_number": "480-988-9108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UCXTRA UMBRELLA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-18",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "PANDURO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CHIEF ADMIN OFFICER",
        "authorized_official_telephone_number": "480-663-2432"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "412931",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Urgent Care Extra AZ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.