PHOENIX CHILDREN'S MEDICAL GROUP (NPI# 1487814240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487814240 |
| Entity Type | Organization |
| Organization Name | PHOENIX CHILDREN'S MEDICAL GROUP |
| Practice Address |
5131 E Southern Ave Mesa AZ 85206-2799 |
| Mailing Address |
3200 E Camelback Rd Ste 250 Phoenix AZ 85018-2327 |
| Practice Telephone | 6029330002 |
| Practice Fax Number | 6029336216 |
| Mailing Telephone | 6029331815 |
| Mailing Fax Number | 6029331820 |
| Enumeration Date | 2008-06-13 |
| 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 Clinic - East Valley | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154660959 | Phoenix Children's Medical Group | Clinic/Center | 1665 N Avondale Blvd, Avondale, AZ 85392-5003 | 2013-02-14 |
| 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 |
| Street Address |
5131 E SOUTHERN AVE |
| City | MESA |
| State | AZ |
| Zip Code | 85206-2799 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174522890 | Karl M. Baumgartner | Pediatrics | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2005-07-14 |
| 1811452014 | Kimberly Jones | Dietitian, Registered | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2019-02-01 |
| 1023470457 | Michael Haynes | Pediatrics | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2016-03-24 |
| 1932531753 | Deidra C Dexter-hine | Dietitian, Registered | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2013-08-02 |
| 1215271911 | Phoenix Children's Urgent Care Centers | Clinic/Center | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2012-11-19 |
| 1275886434 | Phoenix Children's Hospital, Inc. | General Acute Care Hospital | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2012-10-24 |
| 1881722692 | Ginger Apling Carlson | Psychologist | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2007-03-01 |
| 1043363831 | Adrianna Lazzara | Speech-Language Pathologist | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2007-01-18 |
| 1740263474 | Sanjay J Shah | Pediatrics | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2005-11-28 |
| 1972586006 | Joseph A. Gassen | Pediatrics | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2005-11-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790337665 | Banner Physician Super Specialists Arizona LLC | Clinic/Center | 1450 S Dobson Rd Ste B221, Mesa, AZ 85202-4745 | 2019-07-11 |
| 1558836270 | Cardiac Cath Lab of Mesa, LLC | Clinic/Center | 4555 E Inverness Ave Ste 1, Mesa, AZ 85206-4630 | 2018-10-09 |
| 1477095735 | Mckellips Internal Medicine Pllc | Clinic/Center | 3049 E Mckellips Rd Ste 5, Mesa, AZ 85213-3144 | 2016-11-17 |
| 1558365536 | Shannon Gray | Clinic/Center | 605 N Gilbert Rd, Mesa, AZ 85203-6629 | 2005-06-08 |
| 1033594247 | Banner School Based Clinic | Clinic/Center | 855 W 8th Ave, Mesa, AZ 85210-3401 | 2015-07-29 |
| 1407191216 | Banner Childrens Banner Health Clinic LLC | Clinic/Center | 1220 S Higley Rd Ste 101, Mesa, AZ 85206-4001 | 2012-12-05 |
| 1841573870 | Banner Physician Super Specialists Arizona LLC | Clinic/Center | 1432 S Dobson Rd, Mesa, AZ 85202-4768 | 2011-09-26 |
| 1639323447 | Banner Pediatric Specialists LLC | Clinic/Center | 1432 S Dobson Rd, Mesa, AZ 85202-4768 | 2008-11-06 |
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| 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 |
| 1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
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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.