Active NPI
Childrens Critical Care Associates, P.C.
- Pediatric Critical Care Medicine Physician
- Phoenix, AZ
National Provider Identifier
1629040449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- Legal business name
- CHILDRENS CRITICAL CARE ASSOCIATES, P.C.
- Practice address
- 1919 E Thomas Rd
Suite 1891
Phoenix, AZ 85016-7710 - Phone
- (605) 546-1784
- Fax
- (602) 546-1785
- NPI assigned
- Feb 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert H Graham, M.D.
- Title
- President
- Phone
- (602) 546-1784
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Critical Care Medicine Physician | 2080P0203X | Primary |
Addresses
Primary practice location
1919 E Thomas Rd
Suite 1891
Phoenix, AZ 85016-7710
Mailing address
PO Box 27340
Phoenix, AZ 85061-7340
Phone (602) 943-9200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 841082 | Medicaid | AZ |
National Provider Directory
National Provider DirectoryLocations
1919 E Thomas Rd
Ste 1891
Phoenix, AZ 85016
Phone (602) 933-1784
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pediatric Critical Care Medicine Physician
- Phoenix, AZ
- NPI 1508838343
-
- Pediatric Critical Care Medicine Physician
- Orange, CA
- NPI 1548233018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213228800000",
"number": "1629040449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27340",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850617340",
"telephone_number": "602-943-9200",
"fax_number": "602-216-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 E THOMAS RD",
"address_2": "SUITE 1891",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167710",
"telephone_number": "605-546-1784",
"fax_number": "602-546-1785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILDRENS CRITICAL CARE ASSOCIATES, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-06",
"last_updated": "2008-06-12",
"status": "A",
"authorized_official_last_name": "GRAHAM",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "602-546-1784",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2080P0203X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "841082",
"state": "AZ"
}
],
"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 Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.