Radiant Men's Health Club

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

RADIANT MEN'S HEALTH CLUB

Doing business as

Radiant Mens

Practice address

5940 W Union Hills Dr Ste B100
Glendale, AZ 85308-1313

Phone

(480) 219-7098

NPI assigned

Aug 21, 2024

Organization subpart

No

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

Authorized official

Name

Brian Carlisle, FNP-C

Title

Administrator

Phone

(623) 693-2198

Specialties & licenses 1

Addresses

Other names 1

• Radiant Mens Doing business as

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727568000000",
    "number": "1437982998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6635 W HAPPY VALLEY RD STE A104",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853102609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5940 W UNION HILLS DR STE B100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081313",
            "telephone_number": "480-219-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT MEN'S HEALTH CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-09-29",
        "certification_date": "2024-09-29",
        "status": "A",
        "authorized_official_last_name": "CARLISLE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "623-693-2198",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radiant Mens",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Radiant Mens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dmitry Rabinovich, PHARMD
• Rachel Cisney Aesthetics LLC
• Lauren Raczkowski, OTR/L
• Michael Rada
• Marc Rademaker
• Allen K Radkowsky, M.D.
• Leah Radloff, SLPA
• Christina L Radous, AU.D
• Dana Rae, NP-C
• Rocky Rafi

• Primary Care Clinic/Center in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2024; 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.