NPIMap

Organization Active NPI

Mobile Medical Providers of Arizona, LLC

  • Clinic/Center
  • Mesa, AZ
National Provider Identifier
1982014619
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
AP5421 Issued in AZ
Legal business name
MOBILE MEDICAL PROVIDERS OF ARIZONA, LLC
Practice address
2266 S Dobson Rd Ste 200
Mesa, AZ 85202-6412
Phone
(480) 329-8065
NPI assigned
May 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Mr. Nathan Cloutier, NP-C
Title
Owner
Phone
(480) 329-8065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X AP5421 AZ Primary

Addresses

Primary practice location

2266 S Dobson Rd Ste 200
Mesa, AZ 85202-6412

Mailing address

2266 S Dobson Rd Ste 200
Mesa, AZ 85202-6412
Phone (480) 329-8065

Other identifiers 1

IdentifierTypeStateIssuer
005578MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1982014619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 S DOBSON RD STE 200",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026412",
            "telephone_number": "480-329-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 S DOBSON RD STE 200",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852026412",
            "telephone_number": "480-329-8065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE MEDICAL PROVIDERS OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "CLOUTIER",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-329-8065",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "AP5421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005578",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.