NPIMap

Organization Active NPI

Diamond Girl Rock Dynasty Nonprofit Music Organization

Doing business as Diamond Dynasty

  • Emergency Care Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1902558513
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
DIAMOND GIRL ROCK DYNASTY NONPROFIT MUSIC ORGANIZATION
Doing business as
Diamond Dynasty
Practice address
7552 W Weldon Ave
Phoenix, AZ 85033-3721
Phone
(480) 280-3707
NPI assigned
Jan 25, 2022
Last updated
Jan 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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

Authorized official

Name
Antonette Patrice Pearson
Title
Program Director
Phone
(623) 268-7813

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Emergency Care Clinic/Center 261QE0002X NU Primary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X NU
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU
Non-emergency Medical Transport (VAN) 343900000X NU
Lodging Provider 177F00000X NU
Meals Provider 174200000X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

7552 W Weldon Ave
Phoenix, AZ 85033-3721

Mailing address

7552 W Weldon Ave
Phoenix, AZ 85033-3721
Phone (480) 280-3707

Other identifiers 3

IdentifierTypeStateIssuer
00000789347OtherAZAETNA
00000789346OtherAZBLUECROSS BLUESHIELD
00000789345MedicaidAZ

Other names 1

  • Diamond Dynasty Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL dkremergencyshelters@gmail.com

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1902558513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7552 W WELDON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333721",
            "telephone_number": "480-280-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7552 W WELDON AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850333721",
            "telephone_number": "480-280-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND GIRL ROCK DYNASTY NONPROFIT MUSIC ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "ANTONETTE",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "623-268-7813"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "00000789347",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "00000789346",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000789345",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dkremergencyshelters@gmail.com",
            "affiliation": "N",
            "address_1": "7552 W Weldon Ave",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850333721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Diamond Dynasty",
            "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 Jan 25, 2022; 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.