Organization Active NPI

Immaculate Heart of Mary Family Health Center

  • Family Medicine Physician
  • Chandler, AZ
National Provider Identifier
1508469453
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IMMACULATE HEART OF MARY FAMILY HEALTH CENTER
Practice address
2175 N Alma School Rd Ste 109
Chandler, AZ 85224-2878
Phone
(480) 203-9192
NPI assigned
Nov 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Dr. Charles Armstrong, DONPI 1255743548
Title
Executive Director
Phone
(480) 203-9192

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2175 N Alma School Rd Ste 109
Chandler, AZ 85224-2878

Mailing address

5602 S Jolly Roger Rd
Tempe, AZ 85283-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210316002879 AZ Part B Supplier - Clinic/Group Practice 0143636167 Receives reassigned benefits from 2 practitioners
Practice locations: Chandler, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2198294Immaculate Heart of Mary2175 N Alma School Rd BLDG C Ste 109, Chandler, AZ 85224Provider-performed microscopyOct 29, 2026

National Provider Directory

National Provider Directory

Locations

2175 N Alma School Rd
Ste C109
Chandler, AZ 85224
Phone (480) 219-3766

2175 N Alma School Rd
Ste 104
Chandler, AZ 85224

2175 N Alma School Rd
Chandler, AZ 85224
Phone (480) 814-7800

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1508469453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5602 S JOLLY ROGER RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852832121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 N ALMA SCHOOL RD STE 109",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242878",
            "telephone_number": "480-203-9192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMACULATE HEART OF MARY FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-20",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "480-203-9192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.