PHOENIX CHILDREN'S MEDICAL GROUP (NPI# 1154660959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154660959 |
| Entity Type | Organization |
| Organization Name | PHOENIX CHILDREN'S MEDICAL GROUP |
| Other Organization Name | PHOENIX CHILDREN'S AMBULATORY SPECIALTY CENTER - AVONDALE |
| Practice Address |
1665 N Avondale Blvd Avondale AZ 85392-5003 |
| Mailing Address |
3200 E Camelback Rd Ste 250 Phoenix AZ 85018-2311 |
| Practice Telephone | 6029330005 |
| Practice Fax Number | 6029332478 |
| Mailing Telephone | 6029331815 |
| Mailing Fax Number | 6029331820 |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2019-07-09 |
| Authorized Official Name | RENEE CLARKE (VP, MANAGED CARE) |
| Authorized Official Telephone | 6029331802 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHOENIX CHILDREN'S HOSPITAL, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
SH3107 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 876253 | 05 |
| Other Name | Type Code |
|---|---|
| Phoenix Children's Ambulatory Specialty Center - Avondale | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316203383 | Phoenix Children's Medical Group | Clinic/Center | 6990 E Shea Blvd, Scottsdale, AZ 85254-5200 | 2012-04-04 |
| 1679703441 | Phoenix Children's Medical Group | Clinic/Center | 20325 N 51st Ave, Ste 116, Glendale, AZ 85308-5674 | 2009-07-15 |
| 1487814240 | Phoenix Children's Medical Group | Clinic/Center | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2008-06-13 |
| Street Address |
1665 N AVONDALE BLVD |
| City | AVONDALE |
| State | AZ |
| Zip Code | 85392-5003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811990625 | Philip Smittle Traquair | Pediatrics | 1665 N Avondale Blvd, Avondale, AZ 85392-5006 | 2005-05-24 |
| 1073075552 | Jennifer Nicole Martinez | Physical Therapist | 1665 N Avondale Blvd, Avondale, AZ 85392-5006 | 2019-04-03 |
| 1306307889 | Jenna Mae Warner | Speech-Language Pathologist | 1665 N Avondale Blvd, Avondale, AZ 85392-5006 | 2019-03-27 |
| 1942789367 | Joel Medrano | Nurse Practitioner | 1665 N Avondale Blvd, Avondale, AZ 85392-5006 | 2018-08-07 |
| 1922347723 | Phoenix Children's Urgent Care Centers | Clinic/Center | 1665 N Avondale Blvd, Avondale, AZ 85392-5003 | 2013-02-14 |
| 1710262670 | Brianne J Butcher | Clinical Neuropsychologist | 1665 N Avondale Blvd, Avondale, AZ 85392 | 2011-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972100063 | Arizona Imaging Center, LLC | Radiology | 10825 W Mcdowell Rd Suite 130, Avondale, AZ 85392 | 2020-10-02 |
| 1376159053 | Quick Med Center LLC | Clinic/Center | 10825 W Mcdowell Rd Suite 100, Avondale, AZ 85392 | 2020-09-18 |
| 1225641046 | Ambulatory Surgery Centers, LLC | Clinic/Center | 10825 W Mcdowell Rd Suite 110, Avondale, AZ 85392 | 2020-08-31 |
| 1144842394 | National Cardiovascular Surgery Center, LLC | Clinic/Center | 10825 W Mcdowell Rd, Suite 310, Avondale, AZ 85392 | 2020-05-11 |
| 1073077145 | Lakeview Dentistry P.C., Inc. | Dentist | 10750 W. Mcdowell Road, Bldg. D410, Avondale, AZ 85392 | 2019-01-23 |
| 1699249458 | Elaine Van De Wille | Student in an Organized Health Care Education/Training Program | 3609 N 109th Ave, Avondale, AZ 85392 | 2019-01-15 |
| 1750890075 | West Valley Pediatrics | Nurse Practitioner | 10750 West Mcdowell Rd, Suite G700, Avondale, AZ 85392 | 2017-09-29 |
| 1336675305 | Hope-ann Kamler | Licensed Practical Nurse | 2150 North Santa Fe Blvd, Avondale, AZ 85392 | 2017-05-11 |
| 1790237527 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 10285 West Mcdowell Rd, Ste A-102, Avondale, AZ 85392 | 2016-10-27 |
| 1063969137 | Lorri Ward | Registered Nurse | 12750 W Coronado Rd, Avondale, AZ 85392 | 2016-09-07 |
| Find all providers in zip 85392 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
| 1447799796 | West Valley Otc LLC | Clinic/Center | 12409 W Indian School Rd Ste B210, Avondale, AZ 85392-9505 | 2017-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487254918 | Assyrian Family Health Alliance | Clinic/Center | 10210 N 32nd St Ste C6, Phoenix, AZ 85028-3826 | 2020-10-26 |
| 1659970242 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33300 N 32nd Ave, Phoenix, AZ 85085-8877 | 2020-10-23 |
| 1689273542 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33400 N 32nd Ave Fl 1, Phoenix, AZ 85085-8876 | 2020-10-21 |
| 1629676317 | Bethel Hills Integrated Healthcare | Clinic/Center | 13838 S 46th Pl Ste 300, Phoenix, AZ 85044-7804 | 2020-10-14 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| 1235745464 | Vasco Healthcare Inc | Clinic/Center | 2110 W 24th St Ste A, Yuma, AZ 85364-8878 | 2020-09-22 |
| 1265048490 | Vasco Healthcare Inc | Clinic/Center | 8952 E Desert Cove Ave Ste 204, Scottsdale, AZ 85260-6777 | 2020-09-22 |
| 1164031365 | Healthworks Med Group of Arizona P C | Clinic/Center | 2727 N Central Ave, Phoenix, AZ 85004-1120 | 2020-07-24 |
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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.