NPIMap

Organization Active NPI

Palo Verde Pediatrics PLLC

  • Pediatrics Physician
  • Gilbert, AZ
National Provider Identifier
1750355970
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
15804 Issued in AZ
Legal business name
PALO VERDE PEDIATRICS PLLC
Practice address
120 S Val Vista Dr
Gilbert, AZ 85296-1370
Phone
(480) 733-6500
Fax
(480) 633-3794
NPI assigned
Feb 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mark William Deardorff, M.D.NPI 1700859592
Title
Managing Partner
Phone
(480) 733-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 15804 AZ Primary

Addresses

Primary practice location

120 S Val Vista Dr
Gilbert, AZ 85296-1370

Mailing address

120 S Val Vista Dr
Gilbert, AZ 85296-1370
Phone (480) 733-6500

National Provider Directory

National Provider Directory

Locations

120 S Val Vista Dr
Gilbert, AZ 85296
Phone (480) 733-6500

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750355970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S VAL VISTA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961370",
            "telephone_number": "480-733-6500",
            "fax_number": "480-633-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S VAL VISTA DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961370",
            "telephone_number": "480-733-6500",
            "fax_number": "480-633-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALO VERDE PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEARDORFF",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "480-733-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "15804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.