Active NPI
Carrol E Wheat, D.O.
- Family Medicine Physician
- Glendale, AZ
National Provider Identifier
1972595759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 1642
- Practice address
- 6206 West Bell Road
Suite 5
Glendale, AZ 85308 - Phone
- (602) 375-5440
- Fax
- (623) 516-0950
- NPI assigned
- Aug 18, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 1642 | AZ | Primary |
Addresses
Primary practice location
6206 West Bell Road
Suite 5
Glendale, AZ 85308
Mailing address
2500 W Utopia Rd
Ste. 100
Phoenix, AZ 85027-4171
Phone (602) 214-6148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 234427 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1642 | AZ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379980800000",
"number": "1972595759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 W UTOPIA RD",
"address_2": "STE. 100",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850274171",
"telephone_number": "602-214-6148",
"fax_number": "602-214-6149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6206 WEST BELL ROAD",
"address_2": "SUITE 5",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "85308",
"telephone_number": "602-375-5440",
"fax_number": "623-516-0950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEAT",
"first_name": "CARROL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2013-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "1642",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "234427",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.