MMC DOC MD LLC (NPI# 1427309293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427309293 |
| Entity Type | Organization |
| Organization Name | MMC DOC MD LLC |
| Practice Address |
13216 N Plaza Del Rio Blvd Peoria AZ 85381-4907 |
| Mailing Address |
7298 W Avenida Del Sol Peoria AZ 85383-3257 |
| Practice Telephone | 6239775003 |
| Mailing Telephone | 6233416539 |
| Mailing Fax Number | 7088017128 |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |
| Authorized Official Name | SRINIVASA REDDY (OWNER) |
| Authorized Official Telephone | 6233416539 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208M00000X | Hospitalist | 34403 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS ID - AZ MEDICAID | 956740 | 01 |
| Street Address |
13216 N PLAZA DEL RIO BLVD |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942529268 | Mohamed Khirfan Pllc | Internal Medicine | 13216 N Plaza Del Rio Blvd, Peoria, AZ 85381-4907 | 2010-05-26 |
| 1790136133 | Curahealth Phoenix, LLC | Long Term Care Hospital | 13216 N Plaza Del Rio Blvd, Peoria, AZ 85381-4907 | 2016-06-27 |
| 1871848341 | Dr Bereket A Guangul | Internal Medicine | 13216 N Plaza Del Rio Blvd, Peoria, AZ 85381-4907 | 2012-07-19 |
| 1265732804 | Paradise Radiology LLC | Radiology | 13216 N Plaza Del Rio Blvd, Peoria, AZ 85381-4907 | 2010-10-29 |
| 1578863288 | Car Medical, PC | Internal Medicine | 13216 N Plaza Del Rio Blvd, Peoria, AZ 85381-4907 | 2010-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679051171 | Supai LLC | Hospitalist | 13350 N 94th Dr Ste A101, Peoria, AZ 85381-4826 | 2018-08-06 |
| 1083270938 | Christine Shaw | Hospitalist | 5409 N Knoxville Ave, Peoria, IL 61614-5069 | 2019-05-16 |
| 1578083887 | Andrew Noyce | Hospitalist | 815 Main St Ste A, Peoria, IL 61602-1080 | 2017-06-27 |
| 1376906867 | Illinois Hospital Medicine Associates PC | Hospitalist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2016-04-01 |
| 1316336845 | United Physicians Group LLC | Hospitalist | 13462 W Jesse Red Dr, Peoria, AZ 85383-7904 | 2015-01-21 |
| 1447681044 | Venkat Rao Kakollu | Hospitalist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2013-12-06 |
| 1134489743 | Kindred Healthcare Operating, Inc | Hospitalist | 500 W Romeo B Garrett Ave, Peoria, IL 61605-2301 | 2012-05-17 |
| 1285922831 | Knd Development 59 LLC | Hospitalist | 500 W Romeo B Garrett Ave, Peoria, IL 61605-2301 | 2011-07-18 |
| 1750557815 | Parth Hemantkumar Mehta | Hospitalist | 221 Ne Glen Oak Ave, Peoria, IL 61636-5640 | 2008-05-07 |
| 1629035829 | Tayyaba Irshad | Hospitalist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2006-05-01 |
| Find all providers in PEORIA | ||||
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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.