Organization Active NPI

Freedom Health Vascular LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1740742089
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
FREEDOM HEALTH VASCULAR LLC
Practice address
6036 N 19TH Ave Ste 204
Phoenix, AZ 85015-2104
Phone
(480) 616-0356
Fax
(480) 616-0603
NPI assigned
Apr 4, 2019
Last updated
Dec 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Andrew Doyle
Title
Operations Manager
Phone
(602) 740-5375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

6036 N 19TH Ave Ste 204
Phoenix, AZ 85015-2104

Mailing address

Dept#880390
P.O Box 29650
Phoenix, AZ 85038
Phone (480) 626-1746

Other practice location 1

4915 E Baseline Rd Ste 104
Gilbert, AZ 85234-2966
Phone (480) 616-0356

Other identifiers 1

IdentifierTypeStateIssuer
598527MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1740742089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT#880390",
            "address_2": "P.O BOX 29650",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85038",
            "telephone_number": "480-626-1746",
            "fax_number": "480-626-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6036 N 19TH AVE STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152104",
            "telephone_number": "480-616-0356",
            "fax_number": "480-616-0603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4915 E Baseline Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852342966",
            "country_code": "US",
            "telephone_number": "480-616-0356",
            "fax_number": "480-616-0603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREEDOM HEALTH VASCULAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "602-740-5375"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "598527",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.