NPIMap

Organization Active NPI

Phoenician Medical Center Inc

Doing business as Phoenician Primary Care

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1417737628
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHOENICIAN MEDICAL CENTER INC
Doing business as
Phoenician Primary Care
Practice address
6677 W Thunderbird Rd Ste C142
Glendale, AZ 85306-3760
Phone
(480) 963-1853
Fax
(480) 963-1854
NPI assigned
Oct 4, 2023
Last updated
Dec 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2024

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

Authorized official

Name
Anupam Ahlawat
Title
Coo
Phone
(480) 444-7447

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

6677 W Thunderbird Rd Ste C142
Glendale, AZ 85306-3760

Mailing address

1343 N Alma School Rd Ste 160
Chandler, AZ 85224-5901

Other names 1

  • Phoenician Primary Care Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2067578Phoenician Primary Care6677 W Thunderbird Rd, Suite C142, Glendale, AZ 85306Certificate of waiverOct 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Robert E Bell DO19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

6677 W Thunderbird Rd
Ste C142
Glendale, AZ 85306
Phone (623) 247-1081

NPI Registry JSON

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734307200000",
    "number": "1417737628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 N ALMA SCHOOL RD STE 160",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6677 W THUNDERBIRD RD STE C142",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063760",
            "telephone_number": "480-963-1853",
            "fax_number": "480-963-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENICIAN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "AHLAWAT",
        "authorized_official_first_name": "ANUPAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "480-444-7447"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenician Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenician Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.