NPIMap

Organization Active NPI

Red Mountain Family Medicine

  • Family Medicine Physician
  • Mesa, AZ
National Provider Identifier
1720207087
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2866 Issued in AZ
Legal business name
RED MOUNTAIN FAMILY MEDICINE
Practice address
1635 N Greenfield Rd
#134
Mesa, AZ 85205
Phone
(480) 854-7123
Fax
(480) 854-7627
NPI assigned
Apr 25, 2007
Last updated
Oct 2, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2007

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

Authorized official

Name
Lisa Smith
Title
Billing MGR
Phone
(480) 854-7123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2866 AZ Primary

Addresses

Primary practice location

1635 N Greenfield Rd
#134
Mesa, AZ 85205

Mailing address

1635 N Greenfield Rd
#134
Mesa, AZ 85205
Phone (480) 854-7123

National Provider Directory

National Provider Directory

Locations

1050 E University Dr
Ste 7
Mesa, AZ 85203
Phone (480) 969-0086

1635 N Greenfield Rd
Mesa, AZ 85205
Phone (480) 219-2412

1635 N Greenfield Rd
Ste 134
Mesa, AZ 85205
Phone (480) 854-7123

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1720207087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 N GREENFIELD RD",
            "address_2": "#134",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "480-854-7123",
            "fax_number": "480-854-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 N GREENFIELD RD",
            "address_2": "#134",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "480-854-7123",
            "fax_number": "480-854-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED MOUNTAIN FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "480-854-7123"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "2866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.