Active NPI
Western Med Group LLC
- Interventional Pain Medicine Physician
- Peoria, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- Legal business name
- WESTERN MED GROUP LLC
- Practice address
- 20255 N Lake Pleasant Rd Ste 102
Peoria, AZ 85382-9747 - Phone
- (623) 412-2241
- NPI assigned
- Apr 16, 2021
- Last updated
- Feb 24, 2022
- Organization subpart
- Yes
- Parent organization
- WESTERN MED GROUP LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Thomas Moshiri, MD
- Title
- Manager
- Phone
- (602) 441-3573
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | |||
| Physical Medicine & Rehabilitation Physician | 208100000X | |||
| Interventional Pain Medicine Physician | 208VP0014X | Primary | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
20255 N Lake Pleasant Rd Ste 102
Peoria, AZ 85382-9747
Mailing address
21001 N Tatum Blvd Ste 1630-606
Phoenix, AZ 85050-4242
Phone (602) 354-5310
National Provider Directory
National Provider Directory- Part of
- Western Med Group LLC
Locations
20255 N Lake Pleasant Rd
Ste 102
Peoria, AZ 85382
Phone (623) 376-8225
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Interventional Pain Medicine Physician
- Peoria, AZ
- NPI 1831781574
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Interventional Pain Medicine Physician
- Phoenix, AZ
- NPI 1487628442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618531200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1645660800000",
"number": "1750962353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21001 N TATUM BLVD STE 1630-606",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850504242",
"telephone_number": "602-354-5310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20255 N LAKE PLEASANT RD STE 102",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853829747",
"telephone_number": "623-412-2241"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WESTERN MED GROUP LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WESTERN MED GROUP LLC",
"enumeration_date": "2021-04-16",
"last_updated": "2022-02-24",
"certification_date": "2022-02-24",
"status": "A",
"authorized_official_last_name": "MOSHIRI",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "602-441-3573",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.