ARIZONA STATE UNIVERSITY (NPI# 1912187121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912187121 |
| Entity Type | Organization |
| Organization Name | ARIZONA STATE UNIVERSITY |
| Other Organization Name | ARIZONA STATE UNIVERSITY HEALTH SERVICES |
| Practice Address |
7332 E. Sun Devil Mall Mesa AZ 85212 |
| Mailing Address |
Po Box 872104 Tempe AZ 85287-2104 |
| Practice Telephone | 4807271500 |
| Practice Fax Number | 4807271599 |
| Mailing Telephone | 4807271500 |
| Mailing Fax Number | 4807271599 |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2014-11-03 |
| Authorized Official Name | DR. ALLAN MARKUS (PHYSICIAN/DIRECTOR) |
| Authorized Official Telephone | 4809651145 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | ARIZONA STATE UNIVERSITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207Q00000X | Family Medicine | AZ | Allopathic & Osteopathic Physicians | |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Arizona State University Health Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396072682 | Arizona State University | Clinic/Center | 1555 N Bridalwreath St, Tempe, AZ 85281-1601 | 2009-11-09 |
| 1255511465 | Arizona State University | Family Medicine | 4701 West Thunderbird Road, University Center Building, Room 190, Glendale, AZ 85306 | 2007-11-06 |
| 1164601811 | Arizona State University | Clinic/Center | 1124 N 3rd St, Phoenix, AZ 85004-1805 | 2007-10-30 |
| 1952338865 | Arizona State University | Audiologist | Coor Hall 2211, Tempe, AZ 85287-0102 | 2006-06-27 |
| 1467079020 | Arizona State University | Clinical Medical Laboratory | 1001 S Mcallister Ave, Tempe, AZ 85281-2115 | 2020-06-30 |
| 1063883924 | Arizona State University | Audiologist | 975 S. Myrtle Avenue, Coor Hall 2211, Tempe, AZ 85281 | 2015-10-16 |
| 1477959518 | Arizona State University | Non-Pharmacy Dispensing Site | 500 E Veterans Way, Tempe, AZ 85287-0001 | 2014-11-18 |
| 1821492455 | Arizona State University | Non-Pharmacy Dispensing Site | 500 E Veterans Way, Tempe, AZ 85287-0001 | 2014-10-10 |
| 1265798664 | Arizona State University | Clinic/Center | 500 N 3rd St, Phoenix, AZ 85004-2135 | 2012-04-10 |
| 1194058917 | Arizona State University | Clinic/Center | 2150 E Orange St, Tempe, AZ 85281-4814 | 2009-09-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Arizona State University | 1475 N Scottsdale Rd, Scottsdale, AZ 85257 |
| System for Award Management (SAM) Entities | ARIZONA STATE UNIVERSITY | 300 E University Dr Ste 410, Tempe, AZ 85281-2061 |
| Colorado Business Entities | Arizona State University Foundation for A New American University | 300 E University Dr, Tempe, AZ 85281 |
| Ohio Business Entities | ARIZONA STATE UNIVERSITY FOUNDATION FOR A NEW AMERICAN UNIVERSITY | 300 E. University Dr., Tempe, AZ 85281 |
| Street Address |
7332 E. SUN DEVIL MALL |
| City | MESA |
| State | AZ |
| Zip Code | 85212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922610302 | West Point Optical Group | Optometrist | 10706 E Point Twenty-two Blvd, #107, Mesa, AZ 85212 | 2020-08-18 |
| 1215553565 | Andrew Eugene Pak | Dentist | 10664 East Point Twenty-two Blvd, Mesa, AZ 85212 | 2020-06-23 |
| 1588200265 | Signal Butte Kids Dentistry and Orthodontics, LLP | Dentist | 10664 E. Point Twenty Two Blvd, Mesa, AZ 85212 | 2019-11-18 |
| 1194371526 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 4316 S Signal Butte Rd, Mesa, AZ 85212 | 2019-08-12 |
| 1194200980 | Highbury Dental Management, LLC | Dentist | 4425 S Mountain Rd, Suite 109, Mesa, AZ 85212 | 2018-09-27 |
| 1033623541 | Latanya Olivia Edenburgs | Case Manager/Care Coordinator | 10436 E Radiant Ave., Mesa, AZ 85212 | 2017-11-20 |
| 1205355880 | Linda Okafor | Nurse Practitioner | 4719 S Calderon Circle, Mesa, AZ 85212 | 2017-09-14 |
| 1689121188 | Agh Mesa LLC | General Acute Care Hospital | 9130 East Elliot Road, Mesa, AZ 85212 | 2016-09-01 |
| 1861841918 | Ryan Blake | Dentist | 4425 S. Mountain Road, Ste 109, Mesa, AZ 85212 | 2016-06-09 |
| 1083089460 | White Glove Health | Nurse Practitioner | 2906 S Lynch Cr, Mesa, AZ 85212 | 2015-12-10 |
| Find all providers in zip 85212 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053926410 | Matthew Derrick Miller | Nurse Practitioner | 9354 E Thatcher Cir, Mesa, AZ 85212-8539 | 2020-09-12 |
| 1750995858 | Hayley Madler | Nurse Practitioner | 1061 N Omaha Cir, Mesa, AZ 85205-5023 | 2020-09-04 |
| 1043823800 | Nancy Lynn Mitchell | Nurse Practitioner | 1535 N 26th St, Mesa, AZ 85213-4151 | 2020-08-30 |
| 1003429218 | Krista Ann Clevenger | Nurse Practitioner | 3155 E Southern Ave Ste 203, Mesa, AZ 85204-5521 | 2020-08-26 |
| 1093326290 | Joshua Jackson | Nurse Practitioner | 5432 E Southern Ave Ste 101b, Mesa, AZ 85206-2772 | 2020-08-11 |
| 1790395531 | Kelly C Banonis | Nurse Practitioner | 3322 N Brighton, Mesa, AZ 85207-0997 | 2020-08-06 |
| 1689284911 | Katie Keil | Nurse Practitioner | 1061 N Dobson Rd Ste 107, Mesa, AZ 85201-7576 | 2020-08-02 |
| 1831711670 | Saraswati Hamal | Nurse Practitioner | 4850 S Curie Way, Mesa, AZ 85212-9582 | 2020-05-14 |
| 1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
| 1659992436 | Elizabeth Erb | Nurse Practitioner | 1361 S Alma School Rd, Mesa, AZ 85210-2085 | 2020-05-02 |
| Find all providers in MESA | ||||
Please comment or provide details below to improve the information on ARIZONA STATE UNIVERSITY.
| 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.