Active NPI
Coca Aida Hadjipentchev
- Assisted Living Facility
- Phoenix, AZ
National Provider Identifier
1922271485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- ALH-5691
- Practice address
- 1020 W Pontiac Dr
Phoenix, AZ 85027-5713 - Phone
- (623) 748-8108
- Fax
- (623) 466-7753
- NPI assigned
- Apr 4, 2008
- Last updated
- Apr 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | ALH-5691 | AZ | Primary |
Addresses
Primary practice location
1020 W Pontiac Dr
Phoenix, AZ 85027-5713
Mailing address
1020 W Pontiac Dr
Phoenix, AZ 85027-5713
Phone (623) 748-8108
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 082984 | Other | AZ | AHCCCS PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ALH-5691 | AZ | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207267200000",
"number": "1922271485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1020 W PONTIAC DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850275713",
"telephone_number": "623-748-8108",
"fax_number": "623-466-7753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1020 W PONTIAC DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850275713",
"telephone_number": "623-748-8108",
"fax_number": "623-466-7753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HADJIPENTCHEV",
"first_name": "COCA",
"middle_name": "AIDA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-04",
"last_updated": "2008-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AZ",
"license": "ALH-5691",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS PROVIDER ID",
"identifier": "082984",
"state": "AZ"
}
],
"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 Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.