MOUNTAIN PARK HEALTH CENTER (NPI# 1922105204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922105204 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Practice Address |
140 N Litchfield Rd Ste 200&106 Goodyear AZ 85338-1277 |
| Mailing Address |
3003 N Central Ave Ste 1600 Phoenix AZ 85012-2908 |
| Practice Telephone | 6239366795 |
| Practice Fax Number | 6234788150 |
| Mailing Telephone | 6023233344 |
| Mailing Fax Number | 6023233496 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-02-27 |
| Authorized Official Name | JOHN R SWAGERT (CEO) |
| Authorized Official Telephone | 6023233344 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
| 1811490881 | Mountain Park Health Center | Clinic/Center | 303 E Baseline Rd, Phoenix, AZ 85042-6530 | 2018-03-15 |
| 1487037958 | Mountain Park Health Center | Clinic/Center | 5517 N 17th Ave, Phoenix, AZ 85015-2516 | 2015-07-02 |
| 1386027852 | Mountain Park Health Center | Clinic/Center | 17624 N 31st Ave, Phoenix, AZ 85053-1935 | 2015-07-02 |
| 1740663210 | Mountain Park Health Center | Clinic/Center | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2015-07-02 |
| 1669878567 | Mountain Park Health Center | Clinic/Center | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 | 2014-11-05 |
| 1467630012 | Mountain Park Health Center | Pharmacy | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2008-02-06 |
| 1578741120 | Mountain Park Health Center | Pharmacy | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2008-02-06 |
| 1740387018 | Mountain Park Health Center | Clinic/Center | 6601 West Thomas Road, Phoenix, AZ 85035-5700 | 2006-09-20 |
| 1376640656 | Mountain Park Health Center | Clinic/Center | 1840 E Broadway Rd, Tempe, AZ 85282-1614 | 2006-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOUNTAIN PARK HEALTH CENTER | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 |
| Street Address |
140 N LITCHFIELD RD STE 200&106 |
| City | GOODYEAR |
| State | AZ |
| Zip Code | 85338-1277 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295226884 | Caroline Chang | Dentist | 15530 W Roosevelt St Ste E106, Goodyear, AZ 85338 | 2018-05-20 |
| 1609376714 | Rosanna Alvarez | Licensed Practical Nurse | 17432 W Elaine Dr, Goodyear, AZ 85338 | 2018-02-15 |
| 1023534419 | Jennifer Elizabeth Lawrence Dixon | Social Worker | 319 N Lichfield Rd, Suite 105, Goodyear, AZ 85338 | 2017-08-17 |
| 1346774916 | Vanessa Castillo | Specialist/Technologist | 18035 W. Yuma Rd, Goodyear, AZ 85338 | 2017-04-20 |
| 1386008076 | Hope Behavioral Health Residential Care | Substance Abuse Rehabilitation Facility | 15985 W.williams Street, Goodyear, AZ 85338 | 2016-04-08 |
| 1952760241 | Jeremy John Abdul-haqq | Dentist | 15661 W Roosevelt St Ste 102, Goodyear, AZ 85338 | 2016-02-16 |
| 1417206897 | Kelly Renee Filo | Occupational Therapy Assistant | 10189 S. Hacienda Dr., Goodyear, AZ 85338 | 2012-08-31 |
| 1194015545 | Nancy Ann Amore | Licensed Practical Nurse | 15578 W Yuma Road, Goodyear, AZ 85338 | 2011-04-19 |
| 1932409208 | Chung Counihan | Pharmacist | 9890 S Estrella Parkway, Goodyear, AZ 85338 | 2010-11-02 |
| 1053611327 | Traven Anderson | Pharmacist | 9890 South Estrella Parkway, Goodyear, AZ 85338 | 2010-11-02 |
| Find all providers in zip 85338 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1194207878 | Valle Del Sol, Inc. | Clinic/Center | 1510 S 19th Dr, Phoenix, AZ 85009-6540 | 2018-08-30 |
| 1861970139 | Horizon Health and Wellness, Inc. | Clinic/Center | 374 W Alden Rd, Kearny, AZ 85137-1208 | 2018-07-30 |
| 1578059168 | Native Health | Clinic/Center | 6850 W Indian School Rd Ste Nh1, Phoenix, AZ 85033-3249 | 2018-07-06 |
| 1821582529 | Chiricahua Community Health Centers, Inc | Clinic/Center | 335 South Ocotillo Avenue, Benson, AZ 85602 | 2018-06-18 |
| 1881198992 | Valle Del Sol, Inc. | Clinic/Center | 334 W 10th Pl Ste 100, Mesa, AZ 85201-3499 | 2018-03-22 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1346755295 | Circle The City | Clinic/Center | 210 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
| Find all providers with the same taxonomy | ||||
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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.