NPIMap

Organization Active NPI

Grossman & Grossman, LTD.

  • Community/Behavioral Health Agency
  • Gilbert, AZ
National Provider Identifier
1851711840
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
OTC5871 Issued in AZ
Legal business name
GROSSMAN & GROSSMAN, LTD.
Practice address
3420 S Mercy Rd Ste 109
Gilbert, AZ 85297-0420
Phone
(602) 468-2077
NPI assigned
Apr 17, 2014
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Mrs. Phyllis A Grossman, LPCNPI 1972656296
Title
Administrative Director
Phone
(602) 410-6635

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X OTC5871 AZ Primary

Addresses

Primary practice location

3420 S Mercy Rd Ste 109
Gilbert, AZ 85297-0420

Mailing address

PO Box 14948
Scottsdale, AZ 85267-4948
Phone (602) 468-2077

Other identifiers 1

IdentifierTypeStateIssuer
913430MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120705000176 AZ Part B Supplier - Clinic/Group Practice 3476718057 Receives reassigned benefits from 2 practitioners
6 other NPIs on this enrollment
Practice locations: Phoenix, AZ

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1136 E Harmony Ave
Ste 204
Mesa, AZ 85204

1136 E Harmony Ave
Ste 205
Mesa, AZ 85204

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1851711840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14948",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852674948",
            "telephone_number": "602-468-2077",
            "fax_number": "480-609-9552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 S MERCY RD STE 109",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970420",
            "telephone_number": "602-468-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSMAN & GROSSMAN, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "602-410-6635",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "OTC5871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "913430",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.