Organization Active NPI

Carolyn B Pace MD PC

  • Medical Specialty Clinic/Center
  • Tempe, AZ
National Provider Identifier
1629321302
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
22677 Issued in AZ
Legal business name
CAROLYN B PACE MD PC
Practice address
2600 E Southern Ave
Suite K
Tempe, AZ 85282-7610
Phone
(480) 456-6561
Fax
(480) 491-3500
NPI assigned
Oct 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Authorized official

Name
Carolyn Pace, M.D.NPI 1578594974
Title
Physician
Phone
(480) 456-6561

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
Medical Specialty Clinic/Center 261QM2500X 22677 AZ Primary

Addresses

Primary practice location

2600 E Southern Ave
Suite K
Tempe, AZ 85282-7610

Mailing address

2600 E Southern Ave
Suite K
Tempe, AZ 85282-7610
Phone (480) 456-6561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121105000374 AZ Part B Supplier - Clinic/Group Practice 8820249691 Receives reassigned benefits from 2 practitioners
Practice locations: Tempe, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350518400000",
    "number": "1629321302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE",
            "address_2": "SUITE K",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827610",
            "telephone_number": "480-456-6561",
            "fax_number": "480-491-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 E SOUTHERN AVE",
            "address_2": "SUITE K",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827610",
            "telephone_number": "480-456-6561",
            "fax_number": "480-491-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN B PACE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "480-456-6561",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AZ",
            "license": "22677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.