NPIMap

Organization Active NPI

Afc Physical Medicine of Desert Ridge, PLLC

  • Non-Pharmacy Dispensing Site
  • Phoenix, AZ
National Provider Identifier
1962744722
Registry record updated Apr 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
AFC PHYSICAL MEDICINE OF DESERT RIDGE, PLLC
Practice address
20860 N Tatum Blvd
Suite 290
Phoenix, AZ 85050-4274
Phone
(480) 563-1144
NPI assigned
Mar 20, 2013
Organization subpart
Yes
Parent organization
AFC PHYSICAL MEDICINE OF DESERT RIDGE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 4, 2014

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

Authorized official

Name
Eugenia Ursan, NP
Title
Medical Director
Phone
(480) 563-1144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

20860 N Tatum Blvd
Suite 290
Phoenix, AZ 85050-4274

Mailing address

2980 N Beverly Glen Cir
Suite 301
Los Angeles, CA 90077-1726
Phone (310) 474-9809

National Provider Directory

National Provider Directory
Part of
Afc Physical Medicine of Desert Ridgepllc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1962744722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-474-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20860 N TATUM BLVD",
            "address_2": "SUITE 290",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504274",
            "telephone_number": "480-563-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFC PHYSICAL MEDICINE OF DESERT RIDGE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AFC PHYSICAL MEDICINE OF DESERT RIDGE, PLLC",
        "enumeration_date": "2013-03-20",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "URSAN",
        "authorized_official_first_name": "EUGENIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "480-563-1144",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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, 2014; 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.