Individual provider Active NPI

David Meskhishvili

  • Assisted Living Facility
  • Phoenix, AZ
National Provider Identifier
1750053542
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11948 Issued in AZ
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, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
--OtherN/A

Electronic endpoints 1

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
AL11948AZMDAssisted 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.

Verify at the official NPI Registry.