NPIMap

Organization Active NPI

Concentra Primary Care of Arizona, PA

Doing business as Mesa Family Medical Center

  • Primary Care Clinic/Center
  • Mesa, AZ
National Provider Identifier
1881944619
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CONCENTRA PRIMARY CARE OF ARIZONA, PA
Doing business as
Mesa Family Medical Center
Practice address
1345 E. McKellips Road
Suite 106
Mesa, AZ 85203
Phone
(972) 364-8000
Fax
(214) 775-4502
NPI assigned
Sep 19, 2012
Last updated
Mar 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Authorized official

Name
Dr. John Anderson, DO
Title
President
Phone
(972) 364-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

1345 E. McKellips Road
Suite 106
Mesa, AZ 85203

Mailing address

5080 Spectrum Drive
Suite 1200 West Tower
Addison, TX 75001-4648
Phone (972) 364-8000

Other names 1

  • Mesa Family Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Concentra Primary Care of Arizona PA7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1345 E McKellips Rd
Ste 106
Mesa, AZ 85203
Phone (480) 265-8101

NPI Registry JSON

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1881944619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DRIVE",
            "address_2": "SUITE 1200 WEST TOWER",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "972-364-8000",
            "fax_number": "214-775-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 E. MCKELLIPS ROAD",
            "address_2": "SUITE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85203",
            "telephone_number": "972-364-8000",
            "fax_number": "214-775-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCENTRA PRIMARY CARE OF ARIZONA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-364-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesa Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.