Medically Directed Care Clinic Phoenix, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MEDICALLY DIRECTED CARE CLINIC PHOENIX, LLC

Practice address

1425 S Higley Rd
Gilbert, AZ 85296-4798

Phone

(480) 870-1414

NPI assigned

Dec 7, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Loran Webb

Title

Owner

Phone

(602) 326-5932

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1548037732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 S PONDEROSA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977422",
            "telephone_number": "602-326-5932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S HIGLEY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964798",
            "telephone_number": "480-870-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICALLY DIRECTED CARE CLINIC PHOENIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LORAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-326-5932",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.