Modern Elixir, PLLC

Primary specialty

NaturopathTaxonomy code 175F00000X

Legal business name

MODERN ELIXIR, PLLC

Practice address

6818 N Oracle Rd
Suite 414
Tucson, AZ 85704-4249

Phone

(520) 308-5280

Fax

(520) 308-5281

NPI assigned

Mar 25, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Justin K. Taylor, N.M.D.

Title

Physician

Phone

(520) 981-5042

Specialties & licenses 2

Addresses

Tax ID family

Modern Elixir2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Modern Elixir

  • Specialist
  • Tucson, AZ
  • NPI 1710307590
  NPD tax ID

Locations

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349481600000",
    "number": "1972827574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6818 N ORACLE RD",
            "address_2": "SUITE 414",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044249",
            "telephone_number": "520-308-5280",
            "fax_number": "520-308-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6818 N ORACLE RD",
            "address_2": "SUITE 414",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857044249",
            "telephone_number": "520-308-5280",
            "fax_number": "520-308-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN ELIXIR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2012-10-06",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "520-981-5042",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "N.M.D."
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "21070",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jomaa Mocch
• Casey Shaw Mock, CRNA
• Joy R Mockbee, MD
• Rajiv Modak, MD
• Modern Elixir
• Modern Sports Medicine LLC
• Modern Sports Medicine LLC
• Modern Sports Medicine LLC
• Modern Vascular of Tucson, LLC
• Manuel Modiano, M.D.

• Naturopath in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Naturopath in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2012; 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.