Organization Active NPI

John C. Lincoln, LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Phoenix, AZ
National Provider Identifier
1861624702
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
Legal business name
JOHN C. LINCOLN, LLC
Practice address
1668 W Glendale Ave
Suite 128
Phoenix, AZ 85021-8948
Phone
(623) 780-1999
Fax
(623) 516-0950
NPI assigned
Aug 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Nathan L. Anspach
Title
Senior Vice President
Phone
(623) 780-3751

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X Primary

Addresses

Primary practice location

1668 W Glendale Ave
Suite 128
Phoenix, AZ 85021-8948

Mailing address

PO Box 9907
Phoenix, AZ 85068-0907
Phone (623) 780-1999

Other names 1

  • Deer Valley Family Practice at the Beatitudes Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000717 AZ Part B Supplier - Clinic/Group Practice 1557274057 Receives reassigned benefits from 518 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1861624702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9907",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850680907",
            "telephone_number": "623-780-1999",
            "fax_number": "623-516-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1668 W GLENDALE AVE",
            "address_2": "SUITE 128",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850218948",
            "telephone_number": "623-780-1999",
            "fax_number": "623-516-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C. LINCOLN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "ANSPACH",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "623-780-3751"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deer Valley Family Practice at the Beatitudes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 6, 2011; 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.