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Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CHOOSE TO CHANGE

Practice address

15148 W Cortez St
Surprise, AZ 85379-5237

Phone

(708) 275-9244

NPI assigned

May 12, 2023

Last updated

May 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jermaine Davis

Title

Coo

Phone

(708) 275-9244

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1801586748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15148 W CORTEZ ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15148 W CORTEZ ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853795237",
            "telephone_number": "708-275-9244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOOSE TO CHANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JERMAINE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "708-275-9244"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Janae Christensen
• Christian Care Surprise, Inc. (Fellowship Square Outpatient Rehabilitation)

• Clinic/Center in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.