NPIMap

Organization Active NPI

Epangelia Properties, LLC

Doing business as Arizona Medical Clinic

  • Family Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1780819748
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EPANGELIA PROPERTIES, LLC
Doing business as
Arizona Medical Clinic
Practice address
1847 W. Heatherbrae Drive
Phoenix, AZ 85015-4764
Phone
(602) 274-2100
NPI assigned
May 20, 2009
Last updated
Apr 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Authorized official

Name
Dr. Linda S Som, M.D.NPI 1477511764
Title
Member
Phone
(602) 274-2100

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
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

1847 W. Heatherbrae Drive
Phoenix, AZ 85015-4764

Mailing address

1847 W Heatherbrae Dr
Phoenix, AZ 85015-4764
Phone (602) 274-2100

Other names 1

  • Arizona Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090731000610 AZ Part B Supplier - Clinic/Group Practice 5799838140 Receives reassigned benefits from 21 practitioners
Practice locations: Phoenix, 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
03D1101260Arizona Medical Clinic1847 W Heatherbrae Dr, Ste a, Phoenix, AZ 85015Provider-performed microscopyJun 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Arizna Medical Clinic LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1847 W Heatherbrae Dr
Phoenix, AZ 85015
Phone (602) 249-4508

5140 E Thomas Rd
Phoenix, AZ 85018
Phone (602) 207-8400

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1780819748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1847 W HEATHERBRAE DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154764",
            "telephone_number": "602-274-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1847 W. HEATHERBRAE DRIVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850154764",
            "telephone_number": "602-274-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPANGELIA PROPERTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "SOM",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "602-274-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 21, 2011; 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.