KARISSA A SECORA (NPI# 1669848297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669848297 |
| Entity Type | Individual |
| Full Name | KARISSA A SECORA |
| Credential | PA |
| Practice Address |
240 W Thomas Rd # 400 Phoenix AZ 85013-4407 |
| Practice Telephone | 6024066262 |
| Practice Fax Number | 6024066261 |
| Mailing Telephone | 6024066262 |
| Mailing Fax Number | 6024066261 |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2019-09-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 111354 | 05 |
| Street Address |
240 W THOMAS RD # 400 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85013-4407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518929249 | Paul R Macdonald | Psychiatry & Neurology | 240 W Thomas Rd # 400, Phoenix, AZ 85013-4407 | 2006-04-06 |
| 1144653437 | Damian Esteban Berezovsky | Psychiatry & Neurology | 240 W Thomas Rd # 400, Phoenix, AZ 85013-4407 | 2013-08-09 |
| 1356786800 | Kelly Lauren Braun | Psychiatry & Neurology | 240 W Thomas Rd # 400, Phoenix, AZ 85013-4407 | 2013-05-09 |
| 1780930172 | Ram Narendra Narayan | Psychiatry & Neurology | 240 W Thomas Rd # 400, Phoenix, AZ 85013 | 2012-08-03 |
| 1912137985 | Teddy Si Youn | Internal Medicine | 240 W Thomas Rd # 400, Phoenix, AZ 85013-4407 | 2009-07-23 |
| 1740450295 | Vladimir Shvarts | Psychiatry & Neurology | 240 W Thomas Rd # 400, Phoenix, AZ 85013 | 2008-03-11 |
| 1831297274 | David Wang | Psychiatry & Neurology | 240 W Thomas Rd # 400, Phoenix, AZ 85013-4407 | 2006-09-20 |
| 1255365920 | Susan T Herman | Psychiatry & Neurology | 240 W Thomas Rd # 400, Phoenix, AZ 85013-4407 | 2006-07-10 |
| 1184682882 | Jeremy M Shefner | Psychiatry & Neurology | 240 W Thomas Rd # 400, Phoenix, AZ 85013 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043833700 | Marco Antonio Valdez Espinoza | Student in an Organized Health Care Education/Training Program | 500 W. Thomas Road, Suite 900 A, Phoenix, AZ 85013 | 2020-05-28 |
| 1518588292 | Santiago Garcia Ortiz | Student in an Organized Health Care Education/Training Program | 350w Thomas Rd St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013 | 2020-05-04 |
| 1356811970 | Lynne Shaunte Coleman | Nurse Practitioner | 3633 N 3rd Ave 2019, Phoenix, AZ 85013 | 2018-11-26 |
| 1467949156 | Solterra 3rd Indian School Operations, LLC | Assisted Living Facility | 4000 N 3rd Avenue, Phoenix, AZ 85013 | 2018-04-18 |
| 1083018345 | Romelda Antonio | Nurse Practitioner | 222 W Thomas Rd Ste 212, Phoenix, AZ 85013 | 2014-10-15 |
| 1760890131 | Emmitt Michael Thompson | General Practice | 822 West Earll Drive, Phoenix, AZ 85013 | 2014-07-29 |
| 1902218480 | Sreeja Biswas Roy | Internal Medicine | 350 W Thomas Road, Phoenix, AZ 85013 | 2014-06-02 |
| 1417381120 | Osama Qasim Agha | Internal Medicine | 350 W. Thomas Road, Suite 900a, Phoenix, AZ 85013 | 2013-08-29 |
| 1245679604 | Oculist Exceptional Eyewear Pllc | Optometrist | 5043-b N 7th Ave, Phoenix, AZ 85013 | 2013-06-19 |
| 1760829352 | Gina Wilding | Nurse Practitioner | 500 W Thomas Rd Ste 720, Phoenix, AZ 85013 | 2013-05-23 |
| Find all providers in zip 85013 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1659848208 | Pacific Dental Services Foundation | Physician Assistant | 4559 E. Bell Road, Ste 106, Phoenix, AZ 85032 | 2018-10-31 |
| 1124502372 | Amanda Rose Jones | Physician Assistant | 36427 N 14th St, Phoenix, AZ 85086-7506 | 2018-09-23 |
| 1639681745 | Martha Lopez | Physician Assistant | 7010 E Chauncey Ln Ste 210, Phoenix, AZ 85054-3115 | 2017-10-30 |
| 1386153674 | Emily Meredith Eoff | Physician Assistant | 301 W Pasadena Ave Apt 4, Phoenix, AZ 85013-2342 | 2017-09-29 |
| 1659890754 | Greg Horn | Physician Assistant | 20333 N 19th Ave Ste 230, Phoenix, AZ 85027-9901 | 2017-09-11 |
| 1619407269 | Integrative Natural Medicine | Physician Assistant | 2025 E Campbell Ave, #259, Phoenix, AZ 85016-8501 | 2017-06-15 |
| 1174996870 | Jyoti Sharma | Physician Assistant | 13838 S 46th Pl Ste 120, Phoenix, AZ 85044-7801 | 2015-11-04 |
| 1487025086 | Shaye Harrel | Physician Assistant | 9305 W Thomas Rd Ste 478, Phoenix, AZ 85037-3375 | 2015-10-08 |
| 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.