NPIMap

Organization Active NPI

Cactus Medical Center LLC

  • General Practice Physician
  • Peoria, AZ
National Provider Identifier
1710487905
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CACTUS MEDICAL CENTER LLC
Practice address
20255 N Lake Pleasant Rd Ste 102
Peoria, AZ 85382-9747
Phone
(623) 376-8225
NPI assigned
Feb 14, 2018
Last updated
Feb 14, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Authorized official

Name
Brandon KulpNPI 1912322520
Title
Owner
Phone
(623) 376-8225

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 NU Primary

Addresses

Primary practice location

20255 N Lake Pleasant Rd Ste 102
Peoria, AZ 85382-9747

Mailing address

20255 N Lake Pleasant Rd Ste 102
Peoria, AZ 85382-9747
Phone (623) 376-8225

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1710487905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20255 N LAKE PLEASANT RD STE 102",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829747",
            "telephone_number": "623-376-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20255 N LAKE PLEASANT RD STE 102",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853829747",
            "telephone_number": "623-376-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CACTUS MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "KULP",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-376-8225"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.