Organization Active NPI

Phoenix First Assists LLC

  • Surgical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1801039813
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
PHOENIX FIRST ASSISTS LLC
Practice address
3131 E Clarendon Ave
Suite 102
Phoenix, AZ 85016-7069
Phone
(602) 253-9168
Fax
(602) 251-3126
NPI assigned
Apr 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Authorized official

Name
Hao Kenith Fang, MD
Title
Owner
Phone
(602) 253-9168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

3131 E Clarendon Ave
Suite 102
Phoenix, AZ 85016-7069

Mailing address

3131 E Clarendon Ave
Suite 102
Phoenix, AZ 85016-7069
Phone (602) 253-9168

Other identifiers 1

IdentifierTypeStateIssuer
421193MedicaidAZ

National Provider Directory

National Provider Directory

Locations

3131 E Clarendon Ave
Ste 102
Phoenix, AZ 85016
Phone (602) 253-9168

NPI Registry JSON

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

{
    "created_epoch": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394150400000",
    "number": "1801039813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 E CLARENDON AVE",
            "address_2": "SUITE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167069",
            "telephone_number": "602-253-9168",
            "fax_number": "602-251-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 E CLARENDON AVE",
            "address_2": "SUITE 102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167069",
            "telephone_number": "602-253-9168",
            "fax_number": "602-251-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX FIRST ASSISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2014-03-07",
        "status": "A",
        "authorized_official_last_name": "FANG",
        "authorized_official_first_name": "HAO",
        "authorized_official_middle_name": "KENITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-253-9168",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421193",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 7, 2014; 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.