Active NPI
Constantine Audeh, MD
- Hospitalist Physician
- Glendale, AZ
National Provider Identifier
1902885346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 20953
- Practice address
- 5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306 - Phone
- (602) 865-2627
- Fax
- (602) 865-2631
- NPI assigned
- Jan 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 20953 | AZ | |
| Hospitalist Physician | 208M00000X | 20953 | AZ | Primary |
Addresses
Primary practice location
5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306
Mailing address
5555 W. Thunderbird
Banner Thunderbird Medical Center
Glendale, AZ 85306
Phone (602) 865-2627
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171489 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445385600000",
"number": "1902885346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 W. THUNDERBIRD",
"address_2": "BANNER THUNDERBIRD MEDICAL CENTER",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85306",
"telephone_number": "602-865-2627",
"fax_number": "602-865-2632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5555 W. THUNDERBIRD",
"address_2": "BANNER THUNDERBIRD MEDICAL CENTER",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85306",
"telephone_number": "602-865-2627",
"fax_number": "602-865-2631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUDEH",
"first_name": "CONSTANTINE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-13",
"last_updated": "2015-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "20953",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "AZ",
"license": "20953",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "171489",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.