Phoenix Wellbriety Circle LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHOENIX WELLBRIETY CIRCLE LLC

Practice address

135 E Ray Rd Ste 7
Chandler, AZ 85225-3376

Phone

(602) 529-8777

NPI assigned

Nov 9, 2020

Organization subpart

No

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

Authorized official

Name

Jaki Martinez

Title

Director

Phone

(602) 529-8777

Specialties & licenses 1

Addresses

Electronic endpoints 2

Locations

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1497356109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1934 E CAMELBACK RD STE 120-460",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164126",
            "telephone_number": "602-529-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E RAY RD STE 7",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852253376",
            "telephone_number": "602-529-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX WELLBRIETY CIRCLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-08",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JAKI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "602-529-8777"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://cms.officeally.com/",
            "affiliation": "N",
            "endpointDescription": "Comprehensive Electronic Health Records",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "135 E Ray Rd Ste 7",
            "city": "Chandler",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852253376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://cms.officeally.com/",
            "affiliation": "N",
            "endpointDescription": "Comprehensive Electronic Health Records",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "135 E Ray Rd Ste 7",
            "city": "Chandler",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852253376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.