NPIMap

Organization Active NPI

Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
National Provider Identifier
1669878567
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
OTC0599 Issued in AZ
Legal business name
MOUNTAIN PARK HEALTH CENTER
Practice address
3003 N Central Ave Ste 1600
Phoenix, AZ 85012-2908
Phone
(602) 323-3344
Fax
(602) 323-3496
NPI assigned
Nov 5, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
John SwagertNPI 1720047657
Title
Ceo
Phone
(602) 323-3470

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X OTC0599 AZ Primary

Addresses

Primary practice location

3003 N Central Ave Ste 1600
Phoenix, AZ 85012-2908

Mailing address

3003 N Central Ave Ste 1600
Phoenix, AZ 85012-2908
Phone (602) 323-3345

Other practice location 1

2702 N 3rd St
Ste. 4020
Phoenix, AZ 85004-1130
Phone (602) 323-3345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040119000460 AZ Part B Supplier - Clinic/Group Practice 8325949647 Receives reassigned benefits from 185 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Goodyear, AZ; Tempe, AZ; Phoneix, AZ; Phoenix, AZ; Glendale, AZ

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

140 N Litchfield Rd
Ste 106
Goodyear, AZ 85338
Phone (480) 861-6426

690 N Cofco Center Ct
Ste 230
Phoenix, AZ 85008

Practitioners & affiliated clinicians

Practitioners 192

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.

View all 192

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1669878567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122908",
            "telephone_number": "602-323-3345",
            "fax_number": "602-323-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122908",
            "telephone_number": "602-323-3344",
            "fax_number": "602-323-3496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2702 N 3rd St",
            "address_2": "Ste. 4020",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850041130",
            "country_code": "US",
            "telephone_number": "602-323-3345",
            "fax_number": "602-323-3399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNTAIN PARK HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-05",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "SWAGERT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-323-3470"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AZ",
            "license": "OTC0599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.