NPIMap

Organization Active NPI

Squaw Peak Family Physicians PC

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1578590303
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SQUAW PEAK FAMILY PHYSICIANS PC
Practice address
9327 N 3Rd Street
#100
Phoenix, AZ 85020
Phone
(602) 371-3100
Fax
(602) 371-0050
NPI assigned
Jun 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul J Kelley, MDNPI 1548210602
Title
Owner
Phone
(602) 371-3100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9327 N 3Rd Street
#100
Phoenix, AZ 85020

Mailing address

9327 N 3Rd Street
#100
Phoenix, AZ 85020
Phone (602) 371-3100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 193

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.

View all 193

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1578590303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9327 N 3RD STREET",
            "address_2": "#100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85020",
            "telephone_number": "602-371-3100",
            "fax_number": "602-371-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9327 N 3RD STREET",
            "address_2": "#100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85020",
            "telephone_number": "602-371-3100",
            "fax_number": "602-371-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUAW PEAK FAMILY PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-371-3100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "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 Aug 22, 2020; 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.