MOUNTAIN PARK HEALTH CENTER (NPI# 1487037958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487037958 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Practice Address |
5517 N 17th Ave Phoenix AZ 85015-2516 |
| Mailing Address |
3003 N Central Ave Ste 1600 Phoenix AZ 85012-2908 |
| Practice Telephone | 6022437277 |
| Practice Fax Number | 6023233399 |
| Mailing Telephone | 6023233345 |
| Mailing Fax Number | 6023233399 |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2018-03-13 |
| Authorized Official Name | DR. JOHN R SWAGERT (CEO) |
| Authorized Official Telephone | 6023233242 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OTC 0599 | AZ | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
| 1922105204 | Mountain Park Health Center | Clinic/Center | 140 N Litchfield Rd Ste 200&106, Goodyear, AZ 85338-1277 | 2006-09-20 |
| 1811490881 | Mountain Park Health Center | Clinic/Center | 303 E Baseline Rd, Phoenix, AZ 85042-6530 | 2018-03-15 |
| 1386027852 | Mountain Park Health Center | Clinic/Center | 17624 N 31st Ave, Phoenix, AZ 85053-1935 | 2015-07-02 |
| 1740663210 | Mountain Park Health Center | Clinic/Center | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2015-07-02 |
| 1669878567 | Mountain Park Health Center | Clinic/Center | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 | 2014-11-05 |
| 1467630012 | Mountain Park Health Center | Pharmacy | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2008-02-06 |
| 1578741120 | Mountain Park Health Center | Pharmacy | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2008-02-06 |
| 1740387018 | Mountain Park Health Center | Clinic/Center | 6601 West Thomas Road, Phoenix, AZ 85035-5700 | 2006-09-20 |
| 1376640656 | Mountain Park Health Center | Clinic/Center | 1840 E Broadway Rd, Tempe, AZ 85282-1614 | 2006-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOUNTAIN PARK HEALTH CENTER | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 |
| Street Address |
5517 N 17TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85015-2516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154317477 | Lorraine Schieffer | Nurse Practitioner | 5517 N 17th Ave, Phoenix, AZ 85015-2516 | 2005-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610310 | Leticia Karina Maria Lelli | Student in an Organized Health Care Education/Training Program | 4760 N. 20th Ave, Phx, AZ 85015 | 2020-08-18 |
| 1083100564 | Leen Qutachi | Dentist | 1703 W Bethany Home Rd Ste C1, Phoenix, AZ 85015 | 2018-07-08 |
| 1851820146 | Jeff Biever | Spec/Tech, Cardiovascular | 1517 West Lamar Rd, Phoenix, AZ 85015 | 2017-06-08 |
| 1407230964 | Sean Noonan | Optometrist | 1703 W Bethany Home Rd Ste C3, Phoenix, AZ 85015 | 2015-07-15 |
| 1295141620 | Yehia Saleh | Pharmacist | 4040 North 19th Avenue, Cvs Pharmacy, Phoenix, AZ 85015 | 2014-07-07 |
| 1295160380 | Journey To Prosperity | Custodial Care Facility | 1623 W Denton, Phoenix, AZ 85015 | 2013-09-07 |
| 1124372099 | Facing The Future With Hope | Counselor | 5656 N 17th Ave #c7, Phoenix, AZ 85015 | 2012-10-31 |
| 1700133998 | Srujal Vinubhai Patel | Internal Medicine | 6036 N 19th Ave Ste 312, Phoenix, AZ 85015 | 2012-08-07 |
| 1689933947 | Modern Dental Professionals - Arizona PC | Dentist | 2131 E Camelback Road, Ste 102, Phoenix, AZ 85015 | 2012-05-08 |
| 1528360674 | Fatima Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 2025 W Indian School Road, #705, Phoenix, AZ 85015 | 2010-11-23 |
| Find all providers in zip 85015 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194207878 | Valle Del Sol, Inc. | Clinic/Center | 1510 S 19th Dr, Phoenix, AZ 85009-6540 | 2018-08-30 |
| 1578059168 | Native Health | Clinic/Center | 6850 W Indian School Rd Ste Nh1, Phoenix, AZ 85033-3249 | 2018-07-06 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1346755295 | Circle The City | Clinic/Center | 210 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
| 1437607389 | Neighborhood Outreach Access To Health | Clinic/Center | 20440 N 27th Ave Ste 450, Phoenix, AZ 85027-3240 | 2016-09-20 |
| 1972907129 | Neighborhood Outreach Access To Health | Clinic/Center | 16251 N Cave Creek Rd, Phoenix, AZ 85032-2976 | 2014-10-17 |
| 1982830410 | Native Health | Clinic/Center | 2423 W Dunlap Ave Ste 140, Phoenix, AZ 85021-5818 | 2009-06-10 |
| 1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
| 1770196016 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 106 N. Rose Street, Phoenix, OR 97535 | 2020-08-26 |
| 1164055596 | Circle The City | Clinic/Center | 3522 N 3rd Ave, Phoenix, AZ 85013-3903 | 2020-02-13 |
| Find all providers in PHOENIX | ||||
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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.