ACTIVE KIDS PEDIATRICS, PC (NPI# 1629325378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629325378 |
| Entity Type | Organization |
| Organization Name | ACTIVE KIDS PEDIATRICS, PC |
| Practice Address |
15215 S 48th St Suite 110 Phoenix AZ 85044-9142 |
| Practice Telephone | 4807838960 |
| Practice Fax Number | 4807838967 |
| Mailing Telephone | 4807838960 |
| Mailing Fax Number | 4807838967 |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2012-08-13 |
| Authorized Official Name | DR. JUDITH ROSCH BARNES CLARK (PEDIATRICIAN, CO-OWNER) |
| Authorized Official Telephone | 4807838960 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
A32674 | AZ | Ambulatory Health Care Facilities |
| Street Address |
15215 S 48TH ST SUITE 110 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85044-9142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578561270 | Mark Joseph Page | Optometrist | 15215 S 48th St, Suite # 180, Phoenix, AZ 85044-9142 | 2005-07-07 |
| 1316313661 | Jeffery Arthur Kohler | Dentist | 15215 S 48th St, Suite 190, Phoenix, AZ 85044-9142 | 2015-08-20 |
| 1245659432 | English Dermatology PC | Dermatology | 15215 S 48th St, Suite 120, Phoenix, AZ 85044-9142 | 2014-04-15 |
| 1316375611 | Alcohol Recovery Solutions, Inc. | Community/Behavioral Health | 15215 S 48th St, Suite 150, Phoenix, AZ 85044-9142 | 2013-10-23 |
| 1538503032 | Megan Marie Shoen | Physician Assistant | 15215 S 48th St, Suite 120, Phoenix, AZ 85044-9142 | 2013-04-26 |
| 1356689772 | Arizona Progressive Medical Centers | Chiropractor | 15215 S 48th St, Bldg 5 Suite 156, Phoenix, AZ 85044-9142 | 2013-01-18 |
| 1558690313 | Sleepmed Phoenix, LLC | Clinic/Center | 15215 S 48th St, Suite 133, Phoenix, AZ 85044-9142 | 2009-12-08 |
| 1891930632 | Britt Erika Brennan | Marriage & Family Therapist | 15215 S 48th St, Suite 116, Phoenix, AZ 85044-9142 | 2008-12-08 |
| 1457516338 | Insight Health Corp | Radiology | 15215 S 48th St, Bldg 1, Ste 110, Phoenix, AZ 85044-9142 | 2008-07-21 |
| 1164699328 | Robert B Ogesen II | Psychiatry & Neurology | 15215 S 48th St, Ste 152, Phoenix, AZ 85044 | 2008-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023637345 | Jamie Roshun Dawson | Contractor | 13229 S 48th St Apt 3051, Phoenix, AZ 85044 | 2020-04-16 |
| 1548807514 | The Horizon Chiropractic Center | Clinic/Center | 4425 East Agave Road Suite 104, Phoenix, AZ 85044 | 2019-12-09 |
| 1134777634 | Elite Therapy of Az | Occupational Therapist | 15245 S 48th Street, Phoenix, AZ 85044 | 2019-08-28 |
| 1487217584 | Vitae Felix | Psychologist | 5010 E Warner Rd Ste 213, Phoenix, AZ 85044 | 2019-04-16 |
| 1578082392 | Karena Janiece Herron | Nurse Practitioner | 13625 S 48th St Apt 2100, Phoenix, AZ 85044 | 2017-09-13 |
| 1053847319 | Amanda Girardi | Dentist | 4726 E Verbena Dr, Phoenix, AZ 85044 | 2017-05-05 |
| 1518402593 | Janet Swift | Counselor | 10201 South 51st Street; Suite 130, Phoenix, AZ 85044 | 2016-12-29 |
| 1588074876 | Suzanne Morris | Nurse Practitioner | 4802 E. Ray Rd., Ste 23-364, Phoenix, AZ 85044 | 2014-05-07 |
| 1891117974 | Dr. Cameron Khavari Pllc | Chiropractor | 4001 E Mountain Sky Ave Ste 101, Phoenix, AZ 85044 | 2014-01-09 |
| 1316213416 | Shyam Sundar Tangri | Internal Medicine | 13623 S. 45th St, Phoenix, AZ 85044 | 2012-03-22 |
| Find all providers in zip 85044 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013547686 | Wesley Community Center Inc | Clinic/Center | 1510 S 19th Dr Ste 100, Phoenix, AZ 85009-6540 | 2020-01-22 |
| 1548807514 | The Horizon Chiropractic Center | Clinic/Center | 4425 East Agave Road Suite 104, Phoenix, AZ 85044 | 2019-12-09 |
| 1467953588 | Acupuncture At Work LLC | Clinic/Center | 3411 Sweet Air Rd Ste A, Phoenix, MD 21131-1825 | 2018-02-23 |
| 1104359397 | Ahavah Incorporated | Clinic/Center | 112 N Central Ave Fl 1, Phoenix, AZ 85004-2309 | 2017-04-05 |
| 1174905038 | The Source Naturopathic Medical Clinic | Clinic/Center | 550 W Indian School Rd Ste 122, Phoenix, AZ 85013-3200 | 2015-06-26 |
| 1386033199 | Greta M. Ivers, Md, Pllc | Clinic/Center | 1825 East Northern Avenue, Suite 125, Phoenix, AZ 85020 | 2015-01-16 |
| 1245667567 | Viridian Health Management | Clinic/Center | 22601 N 19th Ave Ste 240, Phoenix, AZ 85027-1362 | 2013-10-01 |
| 1033361332 | Concentra Health Services, Inc. | Clinic/Center | 3532 West Thomas Road, Phoenix, AZ 85019-4440 | 2008-10-17 |
| 1194973453 | Arizona Sports and Spine Physicians, P.C. | Clinic/Center | 3033 W Bell Rd # 101a, Phoenix, AZ 85053-3000 | 2008-08-28 |
| 1417143322 | Us Medgroup, P.a. | Clinic/Center | 1818 East Sky Harbor Circle, Suite 150, Phoenix, AZ 85034 | 2007-09-25 |
| 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.