1St Allegiant LLC

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

Legal business name

1ST ALLEGIANT LLC

Practice address

21798 E Cherrywood Dr
Queen Creek, AZ 85142-4886

Phone

(480) 332-8436

NPI assigned

May 11, 2018

Organization subpart

No

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

Authorized official

Name

Candice Reed

Title

Owner

Phone

(480) 332-8436

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1525996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525996800000",
    "number": "1982194387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21798 E CHERRYWOOD DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21798 E CHERRYWOOD DR",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424886",
            "telephone_number": "480-332-8436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST ALLEGIANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-11",
        "last_updated": "2018-05-11",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-332-8436"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Queen Creek, AZ
• Developmental - Behavioral Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.