NPIMap

Organization Active NPI

Deseret Medical Associates PLC

  • Family Medicine Physician
  • Gold Canyon, AZ
National Provider Identifier
1962989244
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DESERET MEDICAL ASSOCIATES PLC
Practice address
6410 S Kings Ranch Rd Ste 1
Gold Canyon, AZ 85118
Phone
(480) 981-3000
Fax
(480) 325-3614
NPI assigned
Jul 19, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Authorized official

Name
Robert C Allen, MDNPI 1639195977
Title
Owner
Phone
(480) 761-2500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X

Addresses

Primary practice location

6410 S Kings Ranch Rd Ste 1
Gold Canyon, AZ 85118

Mailing address

6410 S Kings Ranch Rd Ste 1
Gold Canyon, AZ 85118-7352
Phone (480) 761-2500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180918002147 AZ Part B Supplier - Clinic/Group Practice 5698026409 Receives reassigned benefits from 5 practitioners
Practice locations: Gold Canyon, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789430400000",
    "number": "1962989244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD STE 1",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187352",
            "telephone_number": "480-761-2500",
            "fax_number": "480-288-2879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD STE 1",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "85118",
            "telephone_number": "480-981-3000",
            "fax_number": "480-325-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERET MEDICAL ASSOCIATES PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-19",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-761-2500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gold Canyon, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.