Phoenix Diagnostic Services LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PHOENIX DIAGNOSTIC SERVICES LLC

Practice address

109 Hay Street
Ste. 202
Fayetteville, NC 28301

Phone

(910) 778-1312

Fax

(866) 635-1796

NPI assigned

Oct 29, 2024

Organization subpart

No

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

Authorized official

Name

Gina Murray

Title

Ceo

Phone

(910) 778-1312

Specialties & licenses 1

Addresses

Other names 1

• Phoenix Diagnostic Services LLC Former legal business name

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1992527154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HAY STREET",
            "address_2": "STE. 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28301",
            "telephone_number": "910-778-1312",
            "fax_number": "866-635-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 HAY STREET",
            "address_2": "STE. 202",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28301",
            "telephone_number": "910-778-1312",
            "fax_number": "866-635-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX DIAGNOSTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-778-1312"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoenix Diagnostic Services LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Savanna R Phillips
• Zoe Phillips
• Brynn Phlegar, DPT
• Jesse Alexander Phlegar, DPT
• Phoenix Care Services Inc.
• Physicians Total Rehab Inc.
• Phytcare LLC
• Ashlee Elizabeth Pichette, CRNA
• Chaz Pichette
• Shannel Pickens, MS, CCC-SLP

• Clinic/Center in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.