Organization Active NPI

Solomon Amdemariam LLC

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1801958616
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
31855 Issued in AZ
Legal business name
SOLOMON AMDEMARIAM LLC
Practice address
2000 W Bethany Home Rd
Phoenix, AZ 85015-2443
Phone
(623) 594-7866
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Solomon Amdemariam, M.D.
Title
Owner
Phone
(623) 698-6741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 31855 AZ Primary

Addresses

Primary practice location

2000 W Bethany Home Rd
Phoenix, AZ 85015-2443

Mailing address

20280 N 59TH Ave
Suite # 115 PMB 544
Glendale, AZ 85308-6850
Phone (623) 594-7866

National Provider Directory

National Provider Directory

Locations

20280 N 59th Ave
Ste 115
Glendale, AZ 85308
Phone (623) 293-8480

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801958616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20280 N 59TH AVE",
            "address_2": "SUITE # 115 PMB 544",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086850",
            "telephone_number": "623-594-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152443",
            "telephone_number": "623-594-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLOMON AMDEMARIAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AMDEMARIAM",
        "authorized_official_first_name": "SOLOMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-698-6741",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "31855",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 22, 2020; 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.