Organization Active NPI

Family Medical and Wellness Care, PLC

  • Specialist
  • Phoenix, AZ
National Provider Identifier
1821464082
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
26147 Issued in AZ
Legal business name
FAMILY MEDICAL AND WELLNESS CARE, PLC
Practice address
2525 W Beryl Ave
Phoenix, AZ 85021-1606
Phone
(602) 424-7967
NPI assigned
Aug 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

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

Authorized official

Name
Rebecca Goldman, MD
Title
Owner/MD
Phone
(480) 861-8229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 26147 AZ Primary

Addresses

Primary practice location

2525 W Beryl Ave
Phoenix, AZ 85021-1606

Mailing address

4530 E Ray Rd
Ste 130
Phoenix, AZ 85044-6094
Phone (480) 494-2100

National Provider Directory

National Provider Directory

Locations

4530 E Ray Rd
Ste 130
Phoenix, AZ 85044
Phone (480) 494-2100

NPI Registry JSON

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1821464082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E RAY RD",
            "address_2": "STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446094",
            "telephone_number": "480-494-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W BERYL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850211606",
            "telephone_number": "602-424-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL AND WELLNESS CARE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "480-861-8229",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "26147",
            "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 11, 2015; 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.