Cave Creek Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CAVE CREEK CLINIC, LLC

Practice address

2920 E Mohawk LN Ste 101
Phoenix, AZ 85050-4773

Phone

(480) 401-1555

Fax

(800) 930-4408

NPI assigned

Feb 2, 2019

Organization subpart

No

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

Authorized official

Name

Dr. John Sherman Gilliam, MD

Title

Medical Director

Phone

(480) 401-1555

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1549065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1578028684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15029 N THOMPSON PEAK PKWY # B111-438",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602217",
            "telephone_number": "480-401-1555",
            "fax_number": "800-930-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 E MOHAWK LN STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504773",
            "telephone_number": "480-401-1555",
            "fax_number": "800-930-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAVE CREEK CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-02",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "GILLIAM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "SHERMAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "480-401-1555",
        "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": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388615",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600874",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ellen Cavanaugh, APRN
• Terrence J Cavanaugh, MD
• Nicholas Cavaretta, PA-C
• Monica Camille Vinoya Cavarlez-Cowden, MD
• Lorena Patricia Cavazos, C.N.M.
• Cave Creek Consultant PLLC
• Cave Creek Mental Health and Wellness
• Jordan Alexandra Cave, DPT
• Lee Louis Cavellini, OTR/L
• Matthew James Cavendish, D.D.S.

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.