Active NPI
David Meskhishvili
- Assisted Living Facility
- Phoenix, AZ
National Provider Identifier
1750053542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL11948
- Practice address
- 1615 E Le Marche Ave
Phoenix, AZ 85022-3359 - Phone
- (602) 601-4201
- Fax
- (602) 601-4201
- NPI assigned
- Sep 30, 2021
- Last updated
- Sep 30, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL11948 | AZ | Primary |
Addresses
Primary practice location
1615 E Le Marche Ave
Phoenix, AZ 85022-3359
Mailing address
1615 E Le Marche Ave
Phoenix, AZ 85022-3359
Phone (602) 601-4201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| -- | Other | N/A |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://sqlonfhir-dstu2.azurewebsites.net/fhir | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL11948 | AZ | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1750053542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 E LE MARCHE AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850223359",
"telephone_number": "602-601-4201",
"fax_number": "602-601-4201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 E LE MARCHE AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850223359",
"telephone_number": "602-601-4201",
"fax_number": "602-601-4201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MESKHISHVILI",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-30",
"last_updated": "2021-09-30",
"certification_date": "2021-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AZ",
"license": "AL11948",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://sqlonfhir-dstu2.azurewebsites.net/fhir",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1615 E Le Marche Ave",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850223359",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.