NPIMap

Organization Active NPI

Desert Ridge Urgent Care Centers

  • General Practice Physician
  • Chandler, AZ
National Provider Identifier
1972806834
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
3344 Issued in AZ
Legal business name
DESERT RIDGE URGENT CARE CENTERS
Practice address
40 S Kyrene Rd
Suite 3
Chandler, AZ 85226-4675
Phone
(480) 706-0174
Fax
(480) 706-0117
NPI assigned
Dec 15, 2010
Organization subpart
Yes
Parent organization
DESERT RIDGE URGENT CARE CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Authorized official

Name
Dr. Kenneth L Pettit, DO
Title
Owner / Physician
Phone
(480) 706-0174

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 3344 AZ Primary

Addresses

Primary practice location

40 S Kyrene Rd
Suite 3
Chandler, AZ 85226-4675

Mailing address

16515 S 40TH St
Suite 139
Phoenix, AZ 85048-0558
Phone (480) 706-0174

Other names 1

  • Kyrene Urgent Care Doing business as

National Provider Directory

National Provider Directory
Part of
Phoenician Urgent Care

Practitioners & affiliated clinicians

Practitioners 11

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": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1972806834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST",
            "address_2": "SUITE 139",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480558",
            "telephone_number": "480-706-0174",
            "fax_number": "480-706-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 S KYRENE RD",
            "address_2": "SUITE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852264675",
            "telephone_number": "480-706-0174",
            "fax_number": "480-706-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT RIDGE URGENT CARE CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESERT RIDGE URGENT CARE CENTERS",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "PETTIT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "480-706-0174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "AZ",
            "license": "3344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kyrene Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.