NPIMap

Organization Active NPI

Kids Kare Pediatrics PC

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1508829326
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KIDS KARE PEDIATRICS PC
Practice address
521 W Thomas Rd
2ND Floor
Phoenix, AZ 85013-4240
Phone
(602) 867-1252
Fax
(602) 867-1256
NPI assigned
Apr 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Authorized official

Name
Dr. Luz Angela Lopez, MD
Title
Vicepresident
Phone
(602) 867-1252

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

521 W Thomas Rd
2ND Floor
Phoenix, AZ 85013-4240

Mailing address

521 W Thomas Rd
2ND Floor
Phoenix, AZ 85013-4240
Phone (602) 867-1252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140610001454 AZ Part B Supplier - Clinic/Group Practice 1658595806 Receives reassigned benefits from 10 practitioners
Practice locations: Phoenix, AZ; Mesa, AZ

National Provider Directory

National Provider Directory

Locations

9515 W Camelback Rd
Ste 142
Phoenix, AZ 85037
Phone (602) 903-5365

Practitioners & affiliated clinicians

Practitioners 10

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": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1508829326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W THOMAS RD",
            "address_2": "2ND FLOOR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134240",
            "telephone_number": "602-867-1252",
            "fax_number": "602-867-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W THOMAS RD",
            "address_2": "2ND FLOOR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134240",
            "telephone_number": "602-867-1252",
            "fax_number": "602-867-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS KARE PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "ANGELA",
        "authorized_official_title_or_position": "VICEPRESIDENT",
        "authorized_official_telephone_number": "602-867-1252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "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 10, 2014; 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.