NPIMap

Organization Active NPI

Phoenix Children'S Hospital, Inc.

  • Urgent Care Clinic/Center
  • Avondale, AZ
National Provider Identifier
1922347723
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
SH3107 Issued in AZ
Legal business name
PHOENIX CHILDREN'S HOSPITAL, INC.
Practice address
1665 N Avondale Blvd
Avondale, AZ 85392-5003
Phone
(602) 933-0005
Fax
(602) 933-2478
NPI assigned
Feb 14, 2013
Organization subpart
Yes
Parent organization
PHOENIX CHILDREN'S HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Authorized official

Name
Raheel Farough
Title
SVP, Managed Care & Payer Strategy
Phone
(602) 933-3548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X SH3107 AZ Primary

Addresses

Primary practice location

1665 N Avondale Blvd
Avondale, AZ 85392-5003

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008

Other identifiers 1

IdentifierTypeStateIssuer
778399MedicaidAZ

Other names 1

  • Phoenix Children's Urgent Care Centers - Avondale Other name

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Children'S Hospital Inc5 organizations share this tax ID, including this one
Part of
Phoenix Children'S Hospital Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

NPI Registry JSON

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

{
    "created_epoch": "1360800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684368000000",
    "number": "1922347723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 N AVONDALE BLVD",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925003",
            "telephone_number": "602-933-0005",
            "fax_number": "602-933-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX CHILDREN'S HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX CHILDREN'S HOSPITAL, INC.",
        "enumeration_date": "2013-02-14",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A",
        "authorized_official_last_name": "FAROUGH",
        "authorized_official_first_name": "RAHEEL",
        "authorized_official_title_or_position": "SVP, MANAGED CARE & PAYER STRATEGY",
        "authorized_official_telephone_number": "602-933-3548"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AZ",
            "license": "SH3107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "778399",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Children's Urgent Care Centers - Avondale",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Phoenix Children's Urgent Care Centers - Avondale",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Avondale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.