NPIMap

Organization Active NPI

Resilient Health, Inc.

Doing business as Resilient Health

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1790267011
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
RESILIENT HEALTH, INC.
Doing business as
Resilient Health
Practice address
1415 N 1St St
Phoenix, AZ 85004-1604
Phone
(602) 595-5447
Fax
(602) 595-4537
NPI assigned
Sep 4, 2018
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Kimberly Quiros
Title
Coo
Phone
(602) 995-1767

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X OTC9095 AZ
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1415 N 1St St
Phoenix, AZ 85004-1604

Mailing address

2255 W Northern Ave Ste B100
Phoenix, AZ 85021-4936
Phone (602) 995-1767

Other identifiers 1

IdentifierTypeStateIssuer
091528MedicaidAZ

Other names 1

  • Resilient Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110926000247 AZ Part B Supplier - Clinic/Group Practice 6305017245 Receives reassigned benefits from 13 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gilbert, AZ; Phoenix, AZ

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
03D2213675Resilient Health Inc1415 N 1St Street, Phoenix, AZ 85004Certificate of waiverFeb 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Resilient Health15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

3271 E Queen Creek Rd
Ste 101
Gilbert, AZ 85297
Phone (480) 550-3193

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1536019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1790267011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 W NORTHERN AVE STE B100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214936",
            "telephone_number": "602-995-1767",
            "fax_number": "602-995-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 N 1ST ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041604",
            "telephone_number": "602-595-5447",
            "fax_number": "602-595-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-04",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "QUIROS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "602-995-1767"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "AZ",
            "license": "OTC9095",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091528",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Resilient Health",
            "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 Nov 20, 2024; 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.