NPIMap

Organization Active NPI

Supplemental Healthcare

  • Rehabilitation Hospital
  • Phoenix, AZ
National Provider Identifier
1902145766
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
4186 Issued in AZ
Legal business name
SUPPLEMENTAL HEALTHCARE
Practice address
4720 E Cotton Gin Loop
Phoenix, AZ 85040-4823
Phone
(602) 567-9881
NPI assigned
Feb 13, 2013
Last updated
Feb 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Authorized official

Name
Jacqueline Smith
Title
Occupational Therapy Assistant
Phone
(602) 567-9881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 4186 AZ Primary

Addresses

Primary practice location

4720 E Cotton Gin Loop
Phoenix, AZ 85040-4823

Mailing address

4720 E Cotton Gin Loop
Phoenix, AZ 85040-4823
Phone (602) 567-9881

National Provider Directory

National Provider Directory
Tax ID family
Supplemental Healthcare42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Locations

4720 E Cotton Gin Loop
Phoenix, AZ 85040
Phone (602) 567-9881

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1902145766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 E COTTON GIN LOOP",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850404823",
            "telephone_number": "602-567-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 E COTTON GIN LOOP",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850404823",
            "telephone_number": "602-567-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPLEMENTAL HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-13",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPY ASSISTANT",
        "authorized_official_telephone_number": "602-567-9881"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "AZ",
            "license": "4186",
            "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 Feb 13, 2013; 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.