Active NPI
Paul Thomas Lorentsen, M.D.
- Internal Medicine Physician
- Phoenix, AZ
National Provider Identifier
1679693808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 21354
- Practice address
- 1929 W. Fillmore St, BLDG C
The Neighborhood Christian Clinic
Phoenix, AZ 85009 - Phone
- (602) 258-6008
- Fax
- (602) 258-8388
- NPI assigned
- Mar 30, 2007
- Last updated
- Nov 11, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 21354 | AZ | Primary |
| Pediatrics Physician | 208000000X | 21354 | AZ |
Addresses
Primary practice location
1929 W. Fillmore St, BLDG C
The Neighborhood Christian Clinic
Phoenix, AZ 85009
Mailing address
1929 W Fillmore St, BLDG C
The Neighborhood Christian Clinic
Phoenix, AZ 85009
Phone (602) 258-6008
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 404848 | Other | AZ | AHCCCS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21354 | AZ | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Neighborhood Christian Clinic, Inc | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1649703505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289433600000",
"number": "1679693808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1929 W FILLMORE ST, BLDG C",
"address_2": "THE NEIGHBORHOOD CHRISTIAN CLINIC",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85009",
"telephone_number": "602-258-6008",
"fax_number": "602-258-8388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1929 W. FILLMORE ST, BLDG C",
"address_2": "THE NEIGHBORHOOD CHRISTIAN CLINIC",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85009",
"telephone_number": "602-258-6008",
"fax_number": "602-258-8388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LORENTSEN",
"first_name": "PAUL",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-30",
"last_updated": "2010-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "21354",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "21354",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "404848",
"state": "AZ"
}
],
"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 Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.