NPIMap

Organization Active NPI

Honorhealth Medical Group, LLC

Doing business as Deer Valley Medical

  • Family Medicine Physician
  • Glendale, AZ
National Provider Identifier
1720027121
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HONORHEALTH MEDICAL GROUP, LLC
Doing business as
Deer Valley Medical
Practice address
6220 W. Bell Rd.
Suite 100
Glendale, AZ 85308
Phone
(602) 547-7200
Fax
(602) 547-7301
NPI assigned
Jun 4, 2006
Last updated
Sep 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Authorized official

Name
Savas Petrides
Title
SVP/Ceo
Phone
(480) 696-4020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

6220 W. Bell Rd.
Suite 100
Glendale, AZ 85308

Mailing address

2500 W Utopia Rd Ste 100
Phoenix, AZ 85027-4172
Phone (480) 587-5314

Other identifiers 1

IdentifierTypeStateIssuer
640337MedicaidAZ

Other names 2

  • Deer Valley Medical Doing business as
  • John C Lincoln LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000717 AZ Part B Supplier - Clinic/Group Practice 1557274057 Receives reassigned benefits from 518 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

10230 W Happy Valley Pkwy
Ste 100
Peoria, AZ 85383
Phone (623) 266-4699

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1720027121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274172",
            "telephone_number": "480-587-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 W. BELL RD.",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "602-547-7200",
            "fax_number": "602-547-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HONORHEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "PETRIDES",
        "authorized_official_first_name": "SAVAS",
        "authorized_official_title_or_position": "SVP/CEO",
        "authorized_official_telephone_number": "480-696-4020"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640337",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deer Valley Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Deer Valley Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "John C Lincoln LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.