Complete Care Medical Group LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

COMPLETE CARE MEDICAL GROUP LLC

Practice address

1350 E McKellips Rd Ste 5
Mesa, AZ 85203-2739

Phone

(480) 878-4561

NPI assigned

Oct 12, 2018

Organization subpart

No

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

Authorized official

Name

Marie Knasas

Title

Compliance Offier

Phone

(480) 878-4561

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539302400000",
    "number": "1982179297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E MCKELLIPS RD STE 5",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032739",
            "telephone_number": "480-878-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E MCKELLIPS RD STE 5",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032739",
            "telephone_number": "480-878-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-12",
        "last_updated": "2018-10-12",
        "status": "A",
        "authorized_official_last_name": "KNASAS",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "COMPLIANCE OFFIER",
        "authorized_official_telephone_number": "480-878-4561"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Internal Medicine) Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.