Organization Active NPI

John C. Lincoln, LLC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1417399692
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOHN C. LINCOLN, LLC
Practice address
12235 N Cave Creek Rd
Ste. 9
Phoenix, AZ 85022-6509
Phone
(602) 992-7700
Fax
(602) 992-7722
NPI assigned
Jul 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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

Authorized official

Name
Richard Silver
Title
Ceo
Phone
(623) 434-6200

Specialties & licenses 1

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

Addresses

Primary practice location

12235 N Cave Creek Rd
Ste. 9
Phoenix, AZ 85022-6509

Mailing address

PO Box 845635
Los Angeles, CA 90084-5635
Phone (623) 434-6200

Other names 1

  • John C Lincoln Cactus Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000717 AZ Part B Supplier - Clinic/Group Practice 1557274057 Receives reassigned benefits from 518 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549065600000",
    "number": "1417399692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845635",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900845635",
            "telephone_number": "623-434-6200",
            "fax_number": "623-434-6164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12235 N CAVE CREEK RD",
            "address_2": "STE. 9",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850226509",
            "telephone_number": "602-992-7700",
            "fax_number": "602-992-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. LINCOLN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2019-02-02",
        "status": "A",
        "authorized_official_last_name": "SILVER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-434-6200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John C Lincoln Cactus Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "John C Lincoln Cactus Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.