NPIMap

Organization Active NPI

Sun Valley Medical Group

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1437422425
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4105 Issued in AZ
Legal business name
SUN VALLEY MEDICAL GROUP
Practice address
17215 N 72ND Dr
Suite C-125
Glendale, AZ 85308-8558
Phone
(623) 935-7788
NPI assigned
Feb 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Authorized official

Name
Aaron Degroot
Title
Owner
Phone
(623) 935-7788

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 5917 AZ
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 4105 AZ Primary
Urgent Care Clinic/Center 261QU0200X 4105 AZ

Addresses

Primary practice location

17215 N 72ND Dr
Suite C-125
Glendale, AZ 85308-8558

Mailing address

17215 N 72ND Dr
Suite C-125
Glendale, AZ 85308-8558
Phone (623) 935-7788

National Provider Directory

National Provider Directory
Tax ID family
Sun Valley Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1437422425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17215 N 72ND DR",
            "address_2": "SUITE C-125",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088558",
            "telephone_number": "623-935-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17215 N 72ND DR",
            "address_2": "SUITE C-125",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088558",
            "telephone_number": "623-935-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN VALLEY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "DEGROOT",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-935-7788"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5917",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "4105",
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AZ",
            "license": "4105",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 22, 2012; 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.