Organization Active NPI

Phoenix Obstetrics & Gynecology

  • Obstetrics & Gynecology Physician
  • Phoenix, AZ
National Provider Identifier
1972372779
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PHOENIX OBSTETRICS & GYNECOLOGY
Practice address
3650 W Bethany Home Rd
Phoenix, AZ 85019-1967
Phone
(602) 841-0707
Fax
(602) 841-0708
NPI assigned
Dec 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Authorized official

Name
Dr. Kimberly A. Diana-Brooks, DONPI 1801906789
Title
Owner
Phone
(602) 841-0707

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

3650 W Bethany Home Rd
Phoenix, AZ 85019-1967

Mailing address

3650 W Bethany Home Rd
Phoenix, AZ 85019-1967
Phone (602) 841-0707

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0957432Phoenix Obstetrics and Gynecology3650 W Bethany Home Rd, Phoenix, AZ 85019Provider-performed microscopyFeb 18, 2027

National Provider Directory

National Provider Directory

Locations

3650 W Bethany Home Rd
Phoenix, AZ 85019
Phone (602) 841-0707

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1972372779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 W BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850191967",
            "telephone_number": "602-841-0707",
            "fax_number": "602-841-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 W BETHANY HOME RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850191967",
            "telephone_number": "602-841-0707",
            "fax_number": "602-841-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX OBSTETRICS & GYNECOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "DIANA-BROOKS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-841-0707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "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 Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.