Arizona Wellness Medical, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

3991 Issued in AZ

Legal business name

ARIZONA WELLNESS MEDICAL, LLC

Practice address

5750 W Thunderbird Rd Ste E580
Glendale, AZ 85306-4671

Phone

(623) 412-9355

Fax

(623) 412-9356

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Amy J. Archer, D.O.

Title

Doctor

Phone

(623) 412-9355

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972657062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853800279",
            "telephone_number": "623-412-9355",
            "fax_number": "623-412-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 W THUNDERBIRD RD STE E580",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064671",
            "telephone_number": "623-412-9355",
            "fax_number": "623-412-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA WELLNESS MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ARCHER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "623-412-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "AZ",
            "license": "3991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.