NPIMap

Organization Active NPI

Great Tower Recovery, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1831801232
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GREAT TOWER RECOVERY, LLC
Practice address
5501 N 19TH Ave Ste 331
Phoenix, AZ 85015-2455
Phone
(480) 262-4547
NPI assigned
Dec 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Authorized official

Name
Dr. Ifiok Umoren, DNPNPI 1477938850
Title
Co-Owner
Phone
(480) 262-4547

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

5501 N 19TH Ave Ste 331
Phoenix, AZ 85015-2455

Mailing address

31925 N 125TH Ave
Peoria, AZ 85383-5675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240912003318 AZ Part B Supplier - Clinic/Group Practice 3274073523 Receives reassigned benefits from 4 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

5501 N 19th Ave
Ste 425
Phoenix, AZ 85015
Phone (602) 492-9800

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1831801232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31925 N 125TH AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853835675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 N 19TH AVE STE 331",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850152455",
            "telephone_number": "480-262-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT TOWER RECOVERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "UMOREN",
        "authorized_official_first_name": "IFIOK",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "480-262-4547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "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 Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.