NPIMap

Organization Active NPI

Phoenix Indian Medical Center

  • Community Health Registered Nurse
  • Phoenix, AZ
National Provider Identifier
1427101377
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN051810 Issued in AZ
Legal business name
PHOENIX INDIAN MEDICAL CENTER
Practice address
4212 N 16TH St
Phoenix, AZ 85016-5319
Phone
(602) 248-4194
Fax
(602) 200-5381
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Juan J. Lopez, REGISTERED NURSE
Title
Public Health Nurse
Phone
(602) 248-4194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC1500X RN051810 AZ Primary

Addresses

Primary practice location

4212 N 16TH St
Phoenix, AZ 85016-5319

Mailing address

1244 E Bethany Home Rd
36-A
Phoenix, AZ 85014-2043
Phone (602) 266-2281

National Provider Directory

National Provider Directory
Tax ID family
Department of Veteran's Affair200 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427101377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1244 E BETHANY HOME RD",
            "address_2": "36-A",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142043",
            "telephone_number": "602-266-2281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 N 16TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850165319",
            "telephone_number": "602-248-4194",
            "fax_number": "602-200-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX INDIAN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PUBLIC HEALTH NURSE",
        "authorized_official_telephone_number": "602-248-4194",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "AZ",
            "license": "RN051810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.