Ocotillo Family Medicine, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

31233 Issued in AZ

Legal business name

OCOTILLO FAMILY MEDICINE, PLLC

Practice address

16515 S 40TH St
Suite 109
Phoenix, AZ 85048-0558

Phone

(480) 706-0174

NPI assigned

Apr 14, 2006

Organization subpart

No

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

Authorized official

Name

Gil Holland, MD

Title

Owner

Phone

(480) 706-0174

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1982668935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST",
            "address_2": "SUITE 109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480558",
            "telephone_number": "480-706-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16515 S 40TH ST",
            "address_2": "SUITE 109",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480558",
            "telephone_number": "480-706-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCOTILLO FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "GIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-706-0174",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "31233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "522104",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776130",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Ockrassa, BCBA
• Erin L. Ocock, RN BSPA
• Breanna Marie Oconnell, LPN
• Michael Thomas Oconnor, PT
• Ocotillo Counseling, LLC
• Ocotillo Health, LLC
• Ocotillo Pediatric Therapy, LLC
• Octave Behavioral Michigan PC
• Trevor Octavio
• Oculist Exceptional Eyewear PLLC

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.