NPIMap

Organization Active NPI

Phoenician Medical Center Inc

Doing business as Phoenician Primary Care

  • Primary Care Clinic/Center
  • Mesa, AZ
National Provider Identifier
1417737792
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PHOENICIAN MEDICAL CENTER INC
Doing business as
Phoenician Primary Care
Practice address
10720 E Southern Ave Ste 116
Mesa, AZ 85209-3812
Phone
(480) 963-1853
Fax
(480) 963-1854
NPI assigned
Oct 3, 2023
Last updated
Oct 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

10720 E Southern Ave Ste 116
Mesa, AZ 85209-3812

Mailing address

1343 N Alma School Rd Ste 160
Chandler, AZ 85224-5901
Phone (480) 963-1853

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
03D2022860Phoenician Primary Care10720 E Southern Ave #116, Mesa, AZ 85209Certificate of waiverApr 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Phoenician Medical Ctr Inc19 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

10720 E Southern Ave
Ste 116
Mesa, AZ 85209
Phone (480) 365-0050

NPI Registry JSON

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1417737792",
    "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",
            "telephone_number": "480-963-1853",
            "fax_number": "480-963-1854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10720 E SOUTHERN AVE STE 116",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093812",
            "telephone_number": "480-963-1853",
            "fax_number": "480-963-1854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENICIAN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "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": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenician Primary Care",
            "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 Oct 3, 2023; 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.