NPIMap

Organization Active NPI

Angels Valley Community Healthcare Center PLLC

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1689303117
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
ANGELS VALLEY COMMUNITY HEALTHCARE CENTER PLLC
Practice address
14820 N Cave Creek Rd Ste 2
Phoenix, AZ 85032-4951
Phone
(833) 242-0100
NPI assigned
Jun 9, 2022
Last updated
Jan 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Authorized official

Name
Jean Simon Joel Edouard, PA, SA-C
Title
Ceo
Phone
(520) 527-8038

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

14820 N Cave Creek Rd Ste 2
Phoenix, AZ 85032-4951

Mailing address

14820 N Cave Creek Rd Ste 2
Phoenix, AZ 85032-4951
Phone (833) 599-6507

Other practice location 1

3333 W Thunderbird Rd Apt 2069
Phoenix, AZ 85053-8603
Phone (520) 527-8038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220906002813 AZ Part B Supplier - Clinic/Group Practice 8628452927 Receives reassigned benefits from 38 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

6739 W Cactus Rd
Peoria, AZ 85381
Phone (623) 240-1110

14820 N Cave Creek Rd
Ste 2
Phoenix, AZ 85032
Phone (202) 455-0013

Practitioners & affiliated clinicians

Practitioners 40

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 40

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1689303117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14820 N CAVE CREEK RD STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324951",
            "telephone_number": "833-599-6507",
            "fax_number": "480-535-5548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14820 N CAVE CREEK RD STE 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324951",
            "telephone_number": "833-242-0100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 W Thunderbird Rd Apt 2069",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850538603",
            "country_code": "US",
            "telephone_number": "520-527-8038",
            "fax_number": "623-889-0814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ANGELS VALLEY COMMUNITY HEALTHCARE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-09",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "EDOUARD",
        "authorized_official_first_name": "JEAN SIMON JOEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-527-8038",
        "authorized_official_credential": "PA, SA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "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 Jan 6, 2026; 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.