NPIMap

Organization Active NPI

East Valley Hospital, LLC

  • General Acute Care Hospital
  • Chandler, AZ
National Provider Identifier
1689170813
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
EAST VALLEY HOSPITAL, LLC
Practice address
3050 S Dobson Rd
Chandler, AZ 85248-4906
Phone
(713) 660-0555
NPI assigned
Apr 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Tom Vo
Title
Ceo
Phone
(713) 660-0557

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary
Special Hospital 284300000X

Addresses

Primary practice location

3050 S Dobson Rd
Chandler, AZ 85248-4906

Mailing address

6030 S Rice Ave Ste C
Houston, TX 77081-2944
Phone (713) 660-0557

Other names 2

  • Phoenix ER Doing business as
  • Phoenix ER & Medical Hospital Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220308002279 AZ Part A Provider - Hospital 4587058540 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chandler, AZ; Gilbert, AZ

Hospital certification: CCN 030153

Legal name
EAST VALLEY HOSPITAL, LLC
Doing business as
EAST VALLEY ER & HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Oct 14, 2022
Last certification
Oct 14, 2022
Beds
14
Ownership / control type
Private (for profit)
Organization structure
PartnershipProprietary
Incorporated
Feb 14, 2023 in AZ
Enrollment address
5656 S Power Rd
Gilbert, AZ 85295
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
East Valley ER & HospitalCCN 030153
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Phoenix ER and Medical Hospital LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3050 S Dobson Rd
Chandler, AZ 85248
Phone (480) 284-5867

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Thomas T Vo Individual Corporate OfficerCeo Apr 1, 2022
Micro Hospital Holding, LLC Organization, Houston, TX LLC 5% Or Greater Direct Ownership Interest Feb 14, 2022 55%
Danniel Stites Individual Corporate OfficerCmo Apr 1, 2022
Keelyn Marlatt Individual W-2 Managing EmployeeW-2 Employee Apr 1, 2022
Nutex Health Holdco LLC Organization, Houston, TX Holding company 5% Or Greater Direct Ownership Interest Mar 1, 2023 100%
Claudia Fernandez Individual W-2 Managing EmployeeW-2 Employee Apr 1, 2022
Danniel Joseph Stites Organization, Phoenix, AZ Operational/Managerial Control Feb 14, 2022 45%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 17

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1689170813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 S RICE AVE STE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770812944",
            "telephone_number": "713-660-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 S DOBSON RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852484906",
            "telephone_number": "713-660-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-05",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-660-0557"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix ER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenix ER & Medical Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.