NPIMap

Organization Active NPI

Ebony House Inc

  • Primary Care Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1568937407
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EBONY HOUSE INC
Practice address
1616 E Indian School Rd Ste 250
Phoenix, AZ 85016-8614
Phone
(602) 276-4288
NPI assigned
Oct 8, 2018
Last updated
Jul 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Authorized official

Name
Che Jordan
Title
Ceo
Phone
(602) 276-4288

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1616 E Indian School Rd Ste 250
Phoenix, AZ 85016-8614

Mailing address

6222 S 13TH St
Phoenix, AZ 85042-4408
Phone (602) 276-4288

National Provider Directory

National Provider Directory
Tax ID family
Ebony House Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1616 E Indian School Rd
Ste 250
Phoenix, AZ 85016
Phone (602) 276-4288

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1568937407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6222 S 13TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850424408",
            "telephone_number": "602-276-4288",
            "fax_number": "602-232-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 E INDIAN SCHOOL RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168614",
            "telephone_number": "602-276-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBONY HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-08",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CHE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-276-4288"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "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 Jul 26, 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.