NPIMap

Organization Active NPI

Mountain Vista Medical Center LP

  • Psychiatric Hospital Unit
  • Mesa, AZ
National Provider Identifier
1902162639
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
MOUNTAIN VISTA MEDICAL CENTER LP
Practice address
1301 S Crismon Rd
Mesa, AZ 85209-3767
Phone
(480) 358-6100
Fax
(480) 358-6168
NPI assigned
Apr 6, 2012
Last updated
Apr 3, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNTAIN VISTA MEDICAL CENTER LPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Authorized official

Name
Jacob Golich
Title
Hospital Ceo
Phone
(480) 358-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

1301 S Crismon Rd
Mesa, AZ 85209-3767

Mailing address

1301 S Crismon Rd
Attn: Billing
Mesa, AZ 85209-3767
Phone (480) 358-6100

National Provider Directory

National Provider Directory
Part of
Mountain Vista Medical Center LP

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522713600000",
    "number": "1902162639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 S CRISMON RD",
            "address_2": "ATTN: BILLING",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093767",
            "telephone_number": "480-358-6100",
            "fax_number": "480-358-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S CRISMON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093767",
            "telephone_number": "480-358-6100",
            "fax_number": "480-358-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VISTA MEDICAL CENTER LP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNTAIN VISTA MEDICAL CENTER LP",
        "enumeration_date": "2012-04-06",
        "last_updated": "2018-04-03",
        "status": "A",
        "authorized_official_last_name": "GOLICH",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "HOSPITAL CEO",
        "authorized_official_telephone_number": "480-358-6100"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 3, 2018; 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.