Active NPI
Body Wise Weight Loss & Aesthetics Center Inc
- Public Health & General Preventive Medicine Physician
- Gilbert, AZ
National Provider Identifier
1639312960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 21229
- Legal business name
- BODY WISE WEIGHT LOSS & AESTHETICS CENTER INC
- Practice address
- 3921 E Baseline Rd
Suite 100
Gilbert, AZ 85234-2727 - Phone
- (480) 289-5252
- Fax
- (480) 776-5169
- NPI assigned
- Apr 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Paul Alan Mikel, M.D.
- Title
- Physician Owner
- Phone
- (480) 289-5252
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 21229 | AZ | Primary |
Addresses
Primary practice location
3921 E Baseline Rd
Suite 100
Gilbert, AZ 85234-2727
Mailing address
3921 E Baseline Rd
Suite 100
Gilbert, AZ 85234-2727
Phone (480) 289-5252
Other names 1
- BODY WISE MEDICINE
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1239840000000",
"number": "1639312960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3921 E BASELINE RD",
"address_2": "SUITE 100",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342727",
"telephone_number": "480-289-5252",
"fax_number": "480-776-5169"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3921 E BASELINE RD",
"address_2": "SUITE 100",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852342727",
"telephone_number": "480-289-5252",
"fax_number": "480-776-5169"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BODY WISE WEIGHT LOSS & AESTHETICS CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-04-16",
"last_updated": "2009-04-16",
"status": "A",
"authorized_official_last_name": "MIKEL",
"authorized_official_first_name": "PAUL",
"authorized_official_middle_name": "ALAN",
"authorized_official_title_or_position": "PHYSICIAN OWNER",
"authorized_official_telephone_number": "480-289-5252",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "AZ",
"license": "21229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "BODY WISE MEDICINE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.