Mi Doctora

Key facts

NPI

1851707293

Entity type

Organization (NPI type 2)

Primary specialty

Obstetrics & Gynecology Physician 207V00000X

Legal business name

MI DOCTORA

Practice address

1142 E Southern Ave Ste C101
Mesa, AZ 85204-5055

Phone

(480) 782-7380

Fax

(480) 821-3610

NPI assigned

Jul 7, 2014

Organization subpart

No

Authorized official

Name

Heather Harner

Title

Credentialing

Phone

(480) 821-3610

Corporate family (same tax ID) 1

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

• Momdoc Midwives Obstetrics & Gynecology Physician · Gilbert, AZ · NPI 1437565876
  NPD tax ID

Practitioners 1

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

• Omar Antonio Andino-Ortega, MD Obstetrics & Gynecology Physician · Mesa, AZ · NPI 1366028748
  NPD (past) OBSTETRICS & GYNECOLOGY

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

National Provider Directory

Tax ID family

DRS Goodman Partridge OB (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 7, 2014.

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1851707293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 W FRYE RD STE 5",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246273",
            "telephone_number": "480-821-3610",
            "fax_number": "480-821-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 E SOUTHERN AVE STE C101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045055",
            "telephone_number": "480-782-7380",
            "fax_number": "480-821-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI DOCTORA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "HARNER",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "480-821-3610"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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