Organization Active NPI

Express Care

  • Primary Care Clinic/Center
  • Mesa, AZ
National Provider Identifier
1508640996
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EXPRESS CARE
Practice address
5416 E Southern Ave
Mesa, AZ 85206-3622
Phone
(800) 688-2301
NPI assigned
Aug 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Authorized official

Name
Jacqueline Porter
Title
Administrator
Phone
(800) 688-0388

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X
Medical-Surgical Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WM0705X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Medical Specialty Clinic/Center 261QM2500X
Primary Care Clinic/Center 261QP2300X Primary
Religious Nonmedical Health Care Institution 282J00000X
Children's Substance Abuse Rehabilitation Facility 3245S0500X
Non-emergency Medical Transport (VAN) 343900000X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X
Medical-Surgical Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SM0705X

Addresses

Primary practice location

5416 E Southern Ave
Mesa, AZ 85206-3622

Mailing address

5416 E Southern Ave
Mesa, AZ 85206-3622
Phone (800) 688-0388

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1508640996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5416 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063622",
            "telephone_number": "800-688-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5416 E SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063622",
            "telephone_number": "800-688-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "800-688-0388"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.