Phoenix Skin and Wound Care

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

PHOENIX SKIN AND WOUND CARE

Practice address

4634 E Laurel CT
Gilbert, AZ 85234-7849

Phone

(602) 814-1554

NPI assigned

Aug 21, 2025

Organization subpart

No

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

Authorized official

Name

Helen Grace MeridorNPI 1861246860

Title

Owner

Phone

(602) 814-1554

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Helen Grace Meridor

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1861246860

  AZ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1730067489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 MARION BENNET DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891062462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4634 E LAUREL CT",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852347849",
            "telephone_number": "602-814-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX SKIN AND WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "MERIDOR",
        "authorized_official_first_name": "HELEN GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-814-1554"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sylvia Phommalinh, PA-C
• Declan Li Phuong

• Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.