Vanguard Mobile Physicians PLLC

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

Legal business name

VANGUARD MOBILE PHYSICIANS PLLC

Practice address

105 N Pasadena St Ste 3
Gilbert, AZ 85233-5013

Phone

(480) 246-3500

Fax

(480) 246-3525

NPI assigned

Nov 21, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Tarik M Shirif

Title

Ceo, President

Phone

(480) 246-3593

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly P Harte, FNP-BC

  • Family Nurse Practitioner
  • Queen Creek, AZ
  • NPI 1437536158
  Medicare reassignment Care Compare group NPD
• Lisa Marie Mendivil, CNP

  • Adult Health Nurse Practitioner
  • Tucson, AZ
  • NPI 1992541502
  Medicare reassignment Care Compare group NPD
• Khalid M Shirif, M.D.

  • Hospice and Palliative Medicine (Surgery) Physician
  • Gilbert, AZ
  • NPI 1407927130
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1508309626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N PASADENA ST STE 3",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335013",
            "telephone_number": "480-246-3500",
            "fax_number": "480-246-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N PASADENA ST STE 3",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852335013",
            "telephone_number": "480-246-3500",
            "fax_number": "480-246-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD MOBILE PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "SHIRIF",
        "authorized_official_first_name": "TARIK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "480-246-3593",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LC1500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Susan Vancuyck, BA, SPEECH PATHOLOGY
• Dana Vandam
• Jack Anthony Vande Hei
• Kathryn Vandehei, M.ED.
• Erica E Vanderheyden, PSY.D
• Lori Vanhoff
• Natasha Vania
• Christopher Charles Vanison, MD
• Brianne Christine Vannucci, PT, DPT
• Sheila Vanpatten

• Community Health Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Community Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.