NPIMap

Organization Active NPI

Mayo Clinic Arizona

Doing business as Mayo Family Practice-Arrowhead

  • Durable Medical Equipment & Medical Supplies
  • Glendale, AZ
National Provider Identifier
1639007164
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
MAYO CLINIC ARIZONA
Doing business as
Mayo Family Practice-Arrowhead
Practice address
20199 N 75TH Ave
Glendale, AZ 85308-8807
Phone
(623) 561-5252
NPI assigned
May 13, 2026
Last updated
May 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Jeffrey Paul Jackson
Title
Cfo
Phone
(480) 574-3055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

20199 N 75TH Ave
Glendale, AZ 85308-8807

Mailing address

20199 N 75TH Ave
Glendale, AZ 85308-8807

Other names 1

  • Mayo Family Practice-Arrowhead Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wade Wernecke MD11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

20199 N 75th Ave
Glendale, AZ 85308
Phone (623) 561-5252

NPI Registry JSON

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

{
    "created_epoch": "1778630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1639007164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20199 N 75TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20199 N 75TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088807",
            "telephone_number": "623-561-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-13",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "480-574-3055"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mayo Family Practice-Arrowhead",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.