Generations Family Medicine PC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

3874 Issued in AZ

Legal business name

GENERATIONS FAMILY MEDICINE PC

Practice address

13945 W Grand Ave
Suite a-101
Surprise, AZ 85374-2437

Phone

(623) 537-5170

Fax

(623) 537-5274

NPI assigned

Jun 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Karla Sue Vitale, DONPI 1659334779

Title

Owner

Phone

(623) 537-5170

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karla Sue Vitale, D.O.

  • Family Medicine Physician
  • Victoria, TX
  • NPI 1659334779
  NPD (past) Authorized official

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1821293580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13945 W GRAND AVE",
            "address_2": "SUITE A-101",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742437",
            "telephone_number": "623-537-5170",
            "fax_number": "623-537-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13945 W GRAND AVE",
            "address_2": "SUITE A-101",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742437",
            "telephone_number": "623-537-5170",
            "fax_number": "623-537-5274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERATIONS FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "VITALE",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-537-5170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "AZ",
            "license": "3874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "954140",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2Z1716",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7039717",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0442900",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theresa Garrett, RD
• Todd Garrett, DDS
• Michelle B Garza, PT, DPT
• Ricardo Gastelum Lopez
• Belay Z Gebresenbet
• Genoa Healthcare, LLC
• Agie George, BS
• German Dobson CVS LLC
• German Dobson CVS LLC
• German Dobson CVS LLC

• Preferred Provider Organization in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Preferred Provider Organization in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; 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.