Organization Active NPI

Sun Valley Pediatric and Family Urgent Care PC

  • Urgent Care Clinic/Center
  • Chandler, AZ
National Provider Identifier
1629458468
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
SUN VALLEY PEDIATRIC AND FAMILY URGENT CARE PC
Practice address
135 E Ray Rd Ste 3
Chandler, AZ 85225-3376
Phone
(480) 355-5437
Fax
(480) 355-5436
NPI assigned
Jun 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Authorized official

Name
Shibu Thomas
Title
Practice Manager
Phone
(480) 355-5437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

135 E Ray Rd Ste 3
Chandler, AZ 85225-3376

Mailing address

135 E Ray Rd Ste 3
Chandler, AZ 85225-3376
Phone (480) 355-5437

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150914001048 AZ Part B Supplier - Clinic/Group Practice 6507173226 Receives reassigned benefits from 5 practitioners
Practice locations: Chandler, AZ

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1096493Sun Valley Pediatric & Family Urgent Care PC135 E Ray Rd, Ste 3, Chandler, AZ 85225Certificate of waiverMar 4, 2027

National Provider Directory

National Provider Directory

Locations

135 E Ray Rd
Ste 3
Chandler, AZ 85225
Phone (480) 208-4931

801 W Ray Rd
Ste 1
Chandler, AZ 85225
Phone (480) 355-5437

Practitioners & affiliated clinicians

Practitioners 6

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": "1433635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1629458468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E RAY RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852253376",
            "telephone_number": "480-355-5437",
            "fax_number": "480-355-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E RAY RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852253376",
            "telephone_number": "480-355-5437",
            "fax_number": "480-355-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN VALLEY PEDIATRIC AND FAMILY URGENT CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-07",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SHIBU",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "480-355-5437"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.