NPIMap

Organization Active NPI

Phoenix Medical Group, Inc.

  • Orthopedic Chiropractor
  • Riverside, CA
National Provider Identifier
1811339385
Registry record updated Jul 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
Legal business name
PHOENIX MEDICAL GROUP, INC.
Practice address
3576 Arlington Ave
Suite 100
Riverside, CA 92506-3943
Phone
(951) 687-6600
Fax
(951) 687-6601
NPI assigned
Jul 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2013

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

Authorized official

Name
Dr. Brent Prately, MD
Title
Orthopedic
Phone
(951) 687-6600

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

3576 Arlington Ave
Suite 100
Riverside, CA 92506-3943

Mailing address

3576 Arlington Ave
Suite 100
Riverside, CA 92506-3943
Phone (951) 687-6600

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Medical Group Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374624000000",
    "number": "1811339385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3576 ARLINGTON AVE",
            "address_2": "SUITE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063943",
            "telephone_number": "951-687-6600",
            "fax_number": "951-687-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3576 ARLINGTON AVE",
            "address_2": "SUITE 100",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063943",
            "telephone_number": "951-687-6600",
            "fax_number": "951-687-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A",
        "authorized_official_last_name": "PRATELY",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "ORTHOPEDIC",
        "authorized_official_telephone_number": "951-687-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.