Philemon R Merrill Jr., PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1876 Issued in AZ

Practice address

7400 S Power Rd
Suite 120
Gilbert, AZ 85297-9281

Phone

(480) 988-1659

Fax

(480) 988-1871

NPI assigned

Feb 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grand Canyon Family Medicine PC

  • Family Medicine Physician
  • Chandler, AZ
  • NPI 1164510616
  Medicare reassignment
• Physician Group of Arizona Inc

  dba Steward Medical Group of Arizona

  • Specialist
  • Phoenix, AZ
  • NPI 1518137520
  Medicare reassignment
• Physician Group of Arizona Inc

  dba Steward Orthopedic and Sports Medicine

  • Orthopaedic Surgery Physician
  • Phoenix, AZ
  • NPI 1558901215
  NPD
• East Valley Wellness Center, LLC

  • General Practice Physician
  • Gilbert, AZ
  • NPI 1023464542
  NPD (past)
• Foot Ankle Specialty Centers, LLC

  • Foot & Ankle Surgery Podiatrist
  • Gilbert, AZ
  • NPI 1679603724
  NPD (past)

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1639144702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 S POWER RD",
            "address_2": "SUITE 120",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979281",
            "telephone_number": "480-988-1659",
            "fax_number": "480-988-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 S POWER RD",
            "address_2": "SUITE 120",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852979281",
            "telephone_number": "480-988-1659",
            "fax_number": "480-988-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "PHILEMON",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "1876",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "270990-1206",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00059274",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonja Mere
• Amy Louise Merkle, OTR/L
• Clyde Edward Merrill, PA-C
• Daniel Merrill, MD
• Katidiane Merrill
• Jeneal Marie Merriman, OTR/L
• Kaylee Merz
• Mesa Ear Nose and Throat PC
• Mesa Multispecialty, LLC
• Mesa Tempe Allergy & Asthma Clinic PC

• Medical Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.