Individual provider Active NPI

Warren D. Kuipers, MD

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1578566626
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23525 Issued in AZ
Practice address
1205 S 7TH Ave
Phoenix, AZ 85007-3913
Phone
(602) 344-6600
Fax
(602) 344-6601
NPI assigned
May 23, 2005
Last updated
Feb 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 23525 AZ Primary

Addresses

Primary practice location

1205 S 7TH Ave
Phoenix, AZ 85007-3913

Mailing address

2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5000

Other identifiers 1

IdentifierTypeStateIssuer
325052MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070117000526 AZ Practitioner - Family Practice 7810998820 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Jan 30, 2012 Accepting new patients
District Medical Group, Inc CurrentSince Jan 30, 2012 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc Family Medicine Past Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients

Locations

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1578566626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168034",
            "telephone_number": "602-470-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 S 7TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850073913",
            "telephone_number": "602-344-6600",
            "fax_number": "602-344-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUIPERS",
        "first_name": "WARREN",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "23525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325052",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.