NPIMap

Organization Active NPI

Compcare LLC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1508235144
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3344 Issued in AZ
Legal business name
COMPCARE LLC
Practice address
2111 E Highland Ave
Suite B425
Phoenix, AZ 85016-4741
Phone
(480) 688-7491
Fax
(480) 706-0117
NPI assigned
Sep 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Dr. Kenneth Pettit, DO
Title
Owner
Phone
(480) 706-0174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 3344 AZ Primary

Addresses

Primary practice location

2111 E Highland Ave
Suite B425
Phoenix, AZ 85016-4741

Mailing address

2111 E Highland Ave
Suite B425
Phoenix, AZ 85016-4741
Phone (480) 688-7491

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1508235144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 E HIGHLAND AVE",
            "address_2": "SUITE B425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164741",
            "telephone_number": "480-688-7491",
            "fax_number": "480-706-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 E HIGHLAND AVE",
            "address_2": "SUITE B425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164741",
            "telephone_number": "480-688-7491",
            "fax_number": "480-706-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-24",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "PETTIT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-706-0174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 20, 2018; 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.