NPIMap

Organization Active NPI

Maricopa County D.B.a. Maricopa County Depart

  • Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1447410048
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
OTC3761 Issued in AZ
Legal business name
MARICOPA COUNTY D.B.A. MARICOPA COUNTY DEPART
Practice address
1645 E. Roosevelt Street
Clinical Services
Phoenix, AZ 85006
Phone
(608) 506-6660
Fax
(602) 375-0342
NPI assigned
Jun 17, 2008
Organization subpart
Yes
Parent organization
MARICOPA COUNTYD.B.A. MARICOPA COUNTY DEPARTMENT OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Authorized official

Name
Mr. Max Porter
Title
Deputy Director
Phone
(602) 506-6641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X OTC3761 AZ Primary

Addresses

Primary practice location

1645 E. Roosevelt Street
Clinical Services
Phoenix, AZ 85006

Mailing address

1645 E Roosevelt Street
Clinical Services
Phoenix, AZ 85006
Phone (602) 506-6660

Other identifiers 1

IdentifierTypeStateIssuer
097451MedicaidAZ

Other names 1

  • Clinical Services Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
McDowell Clinic13 organizations share this tax ID, including this one
Part of
McDowell Clinic

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1447410048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 E ROOSEVELT STREET",
            "address_2": "CLINICAL SERVICES",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85006",
            "telephone_number": "602-506-6660",
            "fax_number": "602-372-0342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 E. ROOSEVELT STREET",
            "address_2": "CLINICAL SERVICES",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85006",
            "telephone_number": "608-506-6660",
            "fax_number": "602-375-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARICOPA COUNTY D.B.A. MARICOPA COUNTY DEPART",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARICOPA COUNTYD.B.A. MARICOPA COUNTY DEPARTMENT OF HEALTH",
        "enumeration_date": "2008-06-17",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "DEPUTY DIRECTOR",
        "authorized_official_telephone_number": "602-506-6641",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "OTC3761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097451",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Feb 8, 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.