NPIMap

Organization Active NPI

Anthem Physical Medicine LLC

  • General Practice Physician
  • Anthem, AZ
National Provider Identifier
1700251071
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ANTHEM PHYSICAL MEDICINE LLC
Practice address
3624 W Anthem Way
C110
Anthem, AZ 85086-0440
Phone
(623) 551-9950
Fax
(623) 551-9950
NPI assigned
Dec 11, 2015
Last updated
Oct 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Authorized official

Name
Dr. Justin ThompsonNPI 1851797179
Title
Owner
Phone
(435) 760-5896

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
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

3624 W Anthem Way
C110
Anthem, AZ 85086-0440

Mailing address

3624 West Anthem Way
C110
Anthem, AZ 85086
Phone (623) 551-9950

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1700251071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 WEST ANTHEM WAY",
            "address_2": "C110",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "85086",
            "telephone_number": "623-551-9950",
            "fax_number": "623-551-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 W ANTHEM WAY",
            "address_2": "C110",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850860440",
            "telephone_number": "623-551-9950",
            "fax_number": "623-551-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHEM PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-760-5896",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anthem, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.