NPIMap

Organization Active NPI

Glendale Healthcare LLC

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1467869743
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
GLENDALE HEALTHCARE LLC
Practice address
6320 W Union Hills Dr
Ste 1400B
Glendale, AZ 85308-1096
Phone
(602) 889-5833
NPI assigned
Jul 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Martha Trujillo
Title
Credentialing
Phone
(602) 889-5833

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

6320 W Union Hills Dr
Ste 1400B
Glendale, AZ 85308-1096

Mailing address

6320 W Union Hills Dr
Ste 1400B
Glendale, AZ 85308-1096
Phone (602) 889-5833

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1467869743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR",
            "address_2": "STE 1400B",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081096",
            "telephone_number": "602-889-5833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6320 W UNION HILLS DR",
            "address_2": "STE 1400B",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081096",
            "telephone_number": "602-889-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "TRUJILLO",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "602-889-5833"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jul 17, 2014; 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.