Organization Active NPI

My Doc at Home, LLC

  • Registered Nurse
  • Peoria, AZ
National Provider Identifier
1659816247
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN161499 Issued in AZ
Legal business name
MY DOC AT HOME, LLC
Practice address
8633 W Shaw Butte Dr
Peoria, AZ 85345-8186
Phone
(623) 980-6670
NPI assigned
Jan 5, 2017
Last updated
Jan 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Authorized official

Name
Christine Alane Champine, RN
Title
Owner/Operator
Phone
(623) 980-6670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN161499 AZ Primary

Addresses

Primary practice location

8633 W Shaw Butte Dr
Peoria, AZ 85345-8186

Mailing address

8633 W Shaw Butte Dr
Peoria, AZ 85345-8186
Phone (623) 980-6670

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1483574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1659816247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8633 W SHAW BUTTE DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458186",
            "telephone_number": "623-980-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8633 W SHAW BUTTE DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458186",
            "telephone_number": "623-980-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DOC AT HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-05",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "CHAMPINE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "ALANE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "623-980-6670",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN161499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.