SHO GRANT (NPI# 1245785732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245785732 |
| Entity Type | Individual |
| Full Name | SHO GRANT |
| Practice Address |
5750 W Thunderbird Rd Ste B200 Glendale AZ 85306-4664 |
| Mailing Address |
5750 W Thunderbird Rd Suite B200 Glendale AZ 85306-4660 |
| Practice Telephone | 6023751700 |
| Practice Fax Number | 6029781225 |
| Mailing Telephone | 6023751700 |
| Mailing Fax Number | 6029781225 |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5750 W THUNDERBIRD RD STE B200 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85306-4664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538181474 | Ken-ryu Han | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2006-07-23 |
| 1083258966 | Lacey Leann Takhtay | Nurse Practitioner | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2019-11-04 |
| 1417508722 | Christina J Cudzewicz | Physician Assistant | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2019-09-27 |
| 1124365531 | Canyon Urology Services LLC | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2013-01-07 |
| 1831354810 | John Mikel Hubanks | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2008-07-19 |
| 1740324912 | Philip Koi | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2007-02-19 |
| 1053455238 | Canyon State Urology, PC | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2007-02-19 |
| 1538205851 | Tracy Lynne Cumberland | Physician Assistant | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2007-01-30 |
| 1548284441 | Christopher S Stewart | Urology | 5750 W Thunderbird Rd Ste B200, Glendale, AZ 85306-4664 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548784648 | Michelle Weissgerber | Registered Nurse | 6640 W Maui Ln, Glendale, AZ 85306 | 2017-07-31 |
| 1427502947 | Az Interact LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6055 West Caribe Lane, Glendale, AZ 85306 | 2016-08-12 |
| 1649667635 | Richard Moreno Jr. | Physical Therapy Assistant | 6509 W Acapulco Ln, Glendale, AZ 85306 | 2015-04-17 |
| 1568863819 | Alternative Living for You | Assisted Living Facility | 5328 W. Tierra Buena Ln., Glendale, AZ 85306 | 2014-09-05 |
| 1649614561 | Matthew Brownell | Internal Medicine | 5555 W, Thunderbird, Banner Thunderbird Medical Center, Glendale, AZ 85306 | 2013-04-22 |
| 1366736266 | Miles Christenson | Speech-Language Pathologist | 14627 N 60th Ave, Glendale, AZ 85306 | 2011-06-08 |
| 1285928721 | Nathalie Tania Petein-alamshaw | Internal Medicine | 5555 W Thunderbird Road, Glendale, AZ 85306 | 2011-06-01 |
| 1134351869 | William J. Duff | Counselor | 5701 W. Talavi Boulevard, Suite 180, Phoenix, AZ 85306 | 2009-08-13 |
| 1538321369 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 5422 W. Thunderbird, Suite 8, Glendale, AZ 85306 | 2008-07-02 |
| 1316109143 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 5620 W. Thunderbird, Suite D3, Glendale, AZ 85306 | 2008-07-02 |
| Find all providers in zip 85306 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079109 | Elizabeth Yushuva Rpac, Pllc | Physician Assistant | 23220 N 71st Dr, Glendale, AZ 85310-5872 | 2020-10-07 |
| 1033725437 | Kayla Gutierrez | Physician Assistant | 4820 W Mcrae Way, Glendale, AZ 85308-4821 | 2020-09-21 |
| 1487269015 | Olivia Julia Karczewski | Physician Assistant | 7764 76th St, Glendale, NY 11385-8239 | 2020-09-10 |
| 1508470923 | Joseph Robert Walsh | Physician Assistant | 18860 N 75th Dr, Glendale, AZ 85308-5948 | 2020-09-02 |
| 1598384463 | Josi Ann Bernal | Physician Assistant | 17505 N 79th Ave Ste 407, Glendale, AZ 85308-8732 | 2020-04-10 |
| 1497385470 | Elizabeth Sovakian | Physician Assistant | 1000 N Central Ave Ste 140, Glendale, CA 91202-3687 | 2020-01-18 |
| 1689216020 | Zeeshan Ahmad | Physician Assistant | 1101 E Broadway Ste 201, Glendale, CA 91205-1396 | 2019-10-16 |
| 1649821281 | Paige Nelson | Physician Assistant | 6908 W Escuda Dr, Glendale, AZ 85308-5516 | 2019-09-25 |
| 1821641879 | Carelinq Medical Group, Inc. | Physician Assistant | 436 W Colorado St Ste 210a, Glendale, CA 91204-3071 | 2019-07-18 |
| 1538625405 | Armen Avetisyan | Physician Assistant | 1630 Calle Vaquero Apt 207, Glendale, CA 91206-1504 | 2019-02-15 |
| Find all providers in GLENDALE | ||||
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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.