Grand West Family Practice and Wellness LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GRAND WEST FAMILY PRACTICE AND WELLNESS LLC

Doing business as

Grand West Family Practice and Wellness LLC

Practice address

13000 N 103Rd Ave Ste 77
Sun City, AZ 85351-3057

Phone

(480) 284-5650

Fax

(480) 284-6431

NPI assigned

Nov 21, 2023

Last updated

Feb 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shelly Tellman, FNP-CNPI 1427393776

Title

Owner/Manager

Phone

(623) 824-5017

Specialties & licenses 1

Addresses

Other names 1

• GRAND WEST FAMILY PRACTICE AND WELLNESS LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Shelly A Tellman, FNP-C

  • Family Nurse Practitioner
  • Sun City, AZ
  • NPI 1427393776
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1740055599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 N 103RD AVE STE 77",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513057",
            "telephone_number": "480-284-5650",
            "fax_number": "480-284-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 N 103RD AVE STE 77",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853513057",
            "telephone_number": "480-284-5650",
            "fax_number": "480-284-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND WEST FAMILY PRACTICE AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-21",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "TELLMAN",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "623-824-5017",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRAND WEST FAMILY PRACTICE AND WELLNESS LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Gorman, DO
• Sarju Govani, D.O.
• Kristine Gradisher, PA-C
• Meredith Grady
• Grand Dental Care, PC
• Heidi Lee Grande
• Thomas Alan Green, FNP-BC
• Gregory Alan Greenbaum, M.D
• David Lawrence Greene, M.D.
• Lisa Teresa Greene, NP

• Family Medicine Physician in Sun City, AZ
• Providers in Sun City, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.