Imd Physicians Arizona PLLC

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

Legal business name

IMD PHYSICIANS ARIZONA PLLC

Practice address

7250 N 16TH St Ste 104
Phoenix, AZ 85020-5214

Phone

(602) 714-2815

NPI assigned

Dec 19, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Micah D Hale, DO

Title

Ceo

Phone

(831) 818-9833

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

Practitioners 1

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

• Chad Seymour Lewis, M.D.

  • Emergency Medicine Physician
  • Scottsdale, AZ
  • NPI 1275713703
  NPD

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585008000000",
    "number": "1629616727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 E GLACIER PLACE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850295653",
            "telephone_number": "602-318-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 N 16TH ST STE 104",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205214",
            "telephone_number": "602-714-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMD PHYSICIANS ARIZONA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "MICAH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "831-818-9833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "micah.hale@virtualerusa.com",
            "affiliation": "N",
            "endpointDescription": "CEO email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "7250 N 16th St Ste 104",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850205214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Caroline M Imhoff, PA-C
• Jamie Imhoff, LPN
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• All providers in Phoenix, AZ
• Emergency Medical Services (Emergency Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.