Kent W. Myers, MD, PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19579 Issued in AZ

Legal business name

KENT W. MYERS, MD, PLC

Practice address

9965 W Royal Oak Rd
Suite # 2236
Sun City, AZ 85351-6109

Phone

(623) 815-0210

Fax

(623) 815-0212

NPI assigned

Aug 16, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Paul M Shanahan

Title

Billing Manager

Phone

(623) 974-6611

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1598044984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9965 W ROYAL OAK RD",
            "address_2": "SUITE # 2236",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853516109",
            "telephone_number": "623-815-0210",
            "fax_number": "623-815-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9965 W ROYAL OAK RD",
            "address_2": "SUITE # 2236",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853516109",
            "telephone_number": "623-815-0210",
            "fax_number": "623-815-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT W. MYERS, MD, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "SHANAHAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "623-974-6611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "19579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1508813965",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Sun City, AZ
• Providers in Sun City, 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 Aug 16, 2011; 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.