SJ MEDICAL GROUP


Address: 4622 N 35th Ave, Phoenix, AZ 85017-3403
Phone: 6027530667

SJ MEDICAL GROUP (NPI# 1669865408) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1669865408
Entity Type Organization
Organization Name SJ MEDICAL GROUP
Practice Address 4622 N 35th Ave
Phoenix
AZ 85017-3403
Practice Telephone 6027530667
Practice Fax Number 6024412202
Mailing Telephone 6027530667
Mailing Fax Number 6024412202
Enumeration Date 2015-03-17
Last Update Date 2015-03-17
Authorized Official Name IMMACULATA INYANG (PROVIDER)
Authorized Official Telephone 6027530667
Authorized Official Credential DNP
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
AP7650 AZ Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 4622 N 35TH AVE
City PHOENIX
State AZ
Zip Code 85017-3403

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1457766172 Lindsay Allison Love Social Worker 3306 W. Catalina Dr., Phoenix, AZ 85017 2014-06-23
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1801089685 Jonnie Arnold Counselor 3400 Grand Ave, Phoenix, AZ 85017 2007-08-24
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1326675166 Kendrick Wright Nurse Practitioner 2727 E Camelback Rd Apt 525, Phoenix, AZ 85016-4481 2020-03-23
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1538709415 Bertha Nambuye Mbatau Nurse Practitioner 2332 W Calle Marita, Phoenix, AZ 85085-7064 2020-01-08
1790346443 Elena Nickolaevna Klimova Nurse Practitioner 2218 E Wahalla Ln, Phoenix, AZ 85024-1231 2019-06-24
1306341748 Kerry L Oliver Nurse Practitioner 12010 S Warner Elliot Loop Ste 1, Phoenix, AZ 85044-2731 2018-03-28
1891294583 Helena Taboy Nurse Practitioner 34975 N North Valley Pkwy Ste 138, Phoenix, AZ 85086-4030 2018-02-07
1528431152 Judith Harmon Nurse Practitioner 12413 N 41st Pl, Phoenix, AZ 85032-7439 2015-11-04
1386032753 Abcore Medical Group Nurse Practitioner 2023 W Bethany Home Rd, Phoenix, AZ 85015-2444 2015-01-07
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Competitor

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City PHOENIX
Zip Code 85017

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Dataset Information

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.

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