PHOENIX CHILDREN'S HOSPITAL (NPI# 1023475506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023475506 |
| Entity Type | Organization |
| Organization Name | PHOENIX CHILDREN'S HOSPITAL |
| Other Organization Name | PHOENIX CHILDREN'S CARDIOLOGY GROUP |
| Practice Address |
1919 E Thomas Rd Phoenix AZ 85016-7710 |
| Mailing Address |
3200 E Camelback Rd Ste 250 Phoenix AZ 85018-2311 |
| Practice Telephone | 6029333366 |
| Practice Fax Number | 6029334166 |
| Mailing Telephone | 6029331815 |
| Mailing Fax Number | 6029331820 |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |
| Authorized Official Name | MS. ETHEL HOFFMAN (VP, MANAGED CARE) |
| Authorized Official Telephone | 6029331801 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHOENIX CHILDREN'S HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
SH3107 | AZ | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Phoenix Children's Cardiology Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376944298 | Phoenix Children's Hospital | Clinic/Center | 3420 S Mercy Rd, Ste 121, Gilbert, AZ 85297-0419 | 2014-09-10 |
| 1841586773 | Phoenix Children's Hospital | Pharmacy | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2011-06-20 |
| 1598059172 | Phoenix Children's Hospital | Pediatrics | 3333 E Van Buren St, Phoenix, AZ 85008-6812 | 2011-06-01 |
| 1295028587 | Phoenix Children's Hospital | Pediatrics | 3333 E Van Buren St, Phoenix, AZ 85008-6812 | 2011-05-19 |
| 1457402364 | Phoenix Children's Hospital | Clinic/Center | 1920 E Cambridge Ave, Ste 102, Phoenix, AZ 85006-1459 | 2007-01-16 |
| 1386749836 | Phoenix Children's Hospital | Pharmacy | 1919 E Thomas Rd, Bldg B, Phoenix, AZ 85016-7710 | 2006-09-13 |
| 1922112044 | Phoenix Children's Hospital | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-08-18 |
| 1760480503 | Phoenix Children's Hospital | General Acute Care Hospital | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2005-07-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHOENIX CHILDREN'S HOSPITAL, INC. | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 |
| Street Address |
1919 E THOMAS RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-7710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162953 | Richard N Southard | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2005-05-31 |
| 1265049472 | Chelsea Agricola | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-30 |
| 1871109686 | Madeline Rose Mcnamee | Audiologist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-17 |
| 1699380212 | Lindsey N Manz | Dietitian, Registered | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-09-10 |
| 1376156331 | Jena Paige Buck | Occupational Therapist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-28 |
| 1386257244 | Alia Torfa | Registered Nurse | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-28 |
| 1336751999 | Cassandra E Martinez | Registered Nurse | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-17 |
| 1811508708 | Clara A Hart | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-08-13 |
| 1811505571 | Daniela M Giralt | Nurse Practitioner | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-07-20 |
| 1902424179 | Soren B Mickelsen | Speech-Language Pathologist | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2020-07-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
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| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760660369 | John P Breinholt IIi | Pediatrics | Pediatric Cardiology, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2008-02-06 |
| 1336178607 | Jennifer Mary Rutledge | Pediatrics | 4327 E Lupine Ave, Phoenix, AZ 85028-2230 | 2006-06-30 |
| 1861811432 | Arizona Pediatric Cardiology, LLC | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2014-04-10 |
| 1770827933 | Ericka Scheller Mclaughlin | Pediatrics | 1919 E Thomas Rd, Heart Center, 2nd Floor, Phoenix, AZ 85016-7710 | 2012-11-12 |
| 1821314386 | Jordan Daniel Awerbach | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2010-04-08 |
| 1780909275 | Nicholas Huggins | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016 | 2010-03-29 |
| 1508053778 | Rashmi Phanindra Rao | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2007-10-01 |
| 1477628824 | John Edward Lane | Pediatrics | 1919 E Thomas Rd, Main Building, Phoenix, AZ 85016-7710 | 2006-11-21 |
| 1073609418 | Lourdes M Guerrero-tiro | Pediatrics | 1919 E Thomas Rd, Main Building, Phoenix, AZ 85016-7710 | 2006-10-05 |
| 1174631196 | Bruce M Hecht | Pediatrics | 1920 E Cambridge Ave Ste 301, Phoenix, AZ 85006-1464 | 2006-08-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.