NPIMap

Organization Active NPI

Estrella Internal Medicine and Pediatrics PC

  • Internal Medicine Physician
  • Goodyear, AZ
National Provider Identifier
1669426565
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ESTRELLA INTERNAL MEDICINE AND PEDIATRICS PC
Practice address
14541 W Indian School Road
Ste 600
Goodyear, AZ 85338-9243
Phone
(623) 535-5599
Fax
(623) 535-4696
NPI assigned
May 22, 2006
Last updated
Nov 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Authorized official

Name
Dr. Kent M Johnson, M.D.NPI 1386699502
Title
President
Phone
(623) 535-5599

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

14541 W Indian School Road
Ste 600
Goodyear, AZ 85338-9243

Mailing address

14541 W Indian School Road
Ste 600
Goodyear, AZ 85338-9243
Phone (623) 535-5599

National Provider Directory

National Provider Directory

Locations

14541 W Indian School Rd
Goodyear, AZ 85395
Phone (623) 535-5599

14541 W Indian School Rd
#600
Goodyear, AZ 85395
Phone (623) 535-5599

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1669426565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14541 W INDIAN SCHOOL ROAD",
            "address_2": "STE 600",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389243",
            "telephone_number": "623-535-5599",
            "fax_number": "623-535-4696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14541 W INDIAN SCHOOL ROAD",
            "address_2": "STE 600",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389243",
            "telephone_number": "623-535-5599",
            "fax_number": "623-535-4696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTRELLA INTERNAL MEDICINE AND PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-535-5599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; 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.