Organization Active NPI

Healthy Life Family Medicine, PLC

  • Primary Care Clinic/Center
  • Goodyear, AZ
National Provider Identifier
1750416400
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
35067 Issued in AZ
Legal business name
HEALTHY LIFE FAMILY MEDICINE, PLC
Practice address
750 N Estrella Pkwy
Suite 40
Goodyear, AZ 85338-9272
Phone
(602) 574-1890
NPI assigned
Feb 22, 2007
Last updated
May 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2019

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

Authorized official

Name
Dr. John Monroe, MDNPI 1346312451
Title
Ceo
Phone
(602) 574-1890

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
Primary Care Clinic/Center 261QP2300X 35067 AZ Primary

Addresses

Primary practice location

750 N Estrella Pkwy
Suite 40
Goodyear, AZ 85338-9272

Mailing address

PO Box 5204
Goodyear, AZ 85338-0603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070911000242 AZ Part B Supplier - Clinic/Group Practice 4183717804 Receives reassigned benefits from 13 practitioners
Practice locations: Goodyear, AZ

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1073443Healthy Life Family Medicine PLC750 N Estrella Parkway, Suite #40, Goodyear, AZ 85338Provider-performed microscopySep 9, 2027

National Provider Directory

National Provider Directory

Locations

750 N Estrella Pkwy
Ste 40
Goodyear, AZ 85338
Phone (623) 877-6180

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1750416400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5204",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853380603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N ESTRELLA PKWY",
            "address_2": "SUITE 40",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389272",
            "telephone_number": "602-574-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFE FAMILY MEDICINE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-574-1890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "35067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.