NPIMap

Organization Active NPI

Emergency Physicians Southwest, PC

  • Emergency Medicine Physician
  • Mesa, AZ
National Provider Identifier
1912053752
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY PHYSICIANS SOUTHWEST, PC
Practice address
6644 E Baywood Ave
Mesa, AZ 85206-1747
Phone
(480) 321-2000
Fax
(480) 321-4198
NPI assigned
Jan 26, 2007
Last updated
Jan 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Authorized official

Name
Sharon Hardy
Title
Director Provider Enrollment
Phone
(925) 251-6901

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

6644 E Baywood Ave
Mesa, AZ 85206-1747

Mailing address

PO Box 635623
Cincinnati, OH 45263-0001
Phone (925) 924-1600

Other identifiers 2

IdentifierTypeStateIssuer
443747MedicaidAZ
DF7231OtherAZMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070502000382 AZ Part B Supplier - Clinic/Group Practice 2264538529 Receives reassigned benefits from 395 practitioners
Practice locations: Gilbert, AZ; Payson, AZ; Page, AZ; Mesa, AZ; Fort Mohave, AZ; Casa Grande, AZ; Lake Havasu City, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 409

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.

View all 409

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578614400000",
    "number": "1912053752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635623",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452630001",
            "telephone_number": "925-924-1600",
            "fax_number": "925-924-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 E BAYWOOD AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061747",
            "telephone_number": "480-321-2000",
            "fax_number": "480-321-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY PHYSICIANS SOUTHWEST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "925-251-6901"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "443747",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "DF7231",
            "state": "AZ"
        }
    ],
    "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 Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.