THE LITTLE CLINIC (NPI# 1124482864) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124482864 |
| Entity Type | Organization |
| Organization Name | THE LITTLE CLINIC |
| Practice Address |
4204 W Cactus Rd Phoenix AZ 85029 |
| Mailing Address |
4204 W Cactus Rd Phoenix AZ 85029-2924 |
| Practice Telephone | 6025475919 |
| Practice Fax Number | 6025477023 |
| Mailing Telephone | 6025475919 |
| Mailing Fax Number | 6025477023 |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2018-06-13 |
| Authorized Official Name | MARC ROBERT WATKINS (CMO) |
| Authorized Official Telephone | 6154254221 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
AP8609 | AZ | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811399819 | The Little Clinic | Clinic/Center | 2620 Elm Hill Pike, Nashville, TN 37214-3108 | 2014-09-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | The Little Clinic of Colorado LLC | 1014 Vine Street, Cincinnati, OH 45202 |
| Indiana Business Entities | THE LITTLE CLINIC OF IN LLC | 2620 Elm Hill Pike, Nashville, TN 37214 |
| Indiana Business Entities | THE LITTLE CLINIC OF INDIANA LLC | 8 Cadillac Drive, Suite 350, Brentwood, TN 37027 |
| Washington State Corporations | THE LITTLE CLINIC OF WASHINGTON LLC | 8 Cadillac Dr Ste 250, Brentwood, TN 37027 |
| Washington State Corporations | THE LITTLE CLINIC VETERINARY SERVICES INC | 13352 Sr 272, Palouse, WA 99161 |
| Street Address |
4204 W CACTUS RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205209319 | Tatiana Rupp | Nurse Practitioner | 4204 W Cactus Rd, Phoenix, AZ 85029-2924 | 2015-11-11 |
| 1881058238 | Deepthy Jolal | Nurse Practitioner | 4204 W Cactus Rd, Phoenix, AZ 85029-2924 | 2016-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153799 | Haydee Bermudez | Counselor | 3301 North 33rd Ave., Phoenix, AZ 85029 | 2020-10-27 |
| 1871191221 | Covenant Home Health LLC | In Home Supportive Care | 11830 N. 19th Ave, Suite 101 Pendleton, Phoenix, AZ 85029 | 2020-10-16 |
| 1508406745 | Tailored 2 U Psychiatry, Pllc | Nurse Practitioner | 4150 W Peoria Avenue, Suite 116, Phoenix, AZ 85029 | 2020-01-15 |
| 1770125403 | Desert Gem Assisted Living Facility, LLC | Custodial Care Facility | 3236 W. Eugie Avenue, Phoenix, AZ 85029 | 2019-10-15 |
| 1588128623 | Anna Debbs | Counselor | 11221 North 28th Drive, Bldg E, Phoenix, AZ 85029 | 2019-01-23 |
| 1609360007 | Melissa Lynn Denton | Specialist/Technologist | 4014 W Paradise Dr, Phoenix, AZ 85029 | 2018-06-19 |
| 1275038713 | Jamilah Amirah | Behavioral Analyst | 11024 N 28th Dr Ste 110, Phoenix, AZ 85029 | 2018-03-27 |
| 1639687056 | Empower Home Care, LLC. | Home Health | 11225 N 28th Drive, Suite D115e, Phoenix, AZ 85029 | 2018-01-19 |
| 1467975698 | Samantha June Collett | Nurse Practitioner | 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 | 2017-07-19 |
| 1073966347 | Meka Joi Green | Social Worker | 11225 M 28th Dr, Suite C210, Phoenix, AZ 85029 | 2016-07-21 |
| Find all providers in zip 85029 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679196372 | Total Orthopedics, LLC | Clinic/Center | 4701 N 24th St Ste A1, Phoenix, AZ 85016-9145 | 2020-05-28 |
| 1649818501 | Crossroads, Inc. | Clinic/Center | 2002 E Osborn Rd Ste A, Phoenix, AZ 85016-7236 | 2019-12-11 |
| 1952945313 | Arizona Primary Care & Regenerative Medicine LLC | Clinic/Center | 1611 W Silver Pine Dr, Phoenix, AZ 85086-1930 | 2019-10-29 |
| 1336615053 | Terros Inc | Clinic/Center | 2445 W Indianola Ave, Phoenix, AZ 85015-5486 | 2018-10-19 |
| 1568937407 | Ebony House Inc | Clinic/Center | 1616 E Indian School Rd Ste 250, Phoenix, AZ 85016-8614 | 2018-10-08 |
| 1225529134 | Restor Medical & Wellness Pllc | Clinic/Center | 5062 N 19th Ave Ste 102b, Phoenix, AZ 85015-3225 | 2018-05-25 |
| 1891208997 | Real Family Care, Pllc | Clinic/Center | 2601 N 3rd St Ste 301, Phoenix, AZ 85004-1101 | 2017-11-10 |
| 1912417577 | Jean K Marseille | Clinic/Center | 9111 N 7th St, Phoenix, AZ 85020-2515 | 2017-10-09 |
| 1982072096 | Leo J Ankenbrandt Md | Clinic/Center | 12801 N 16th Dr, Phoenix, AZ 85029-2802 | 2015-09-04 |
| 1528443066 | Terros, Inc. | Clinic/Center | 8804 N 23rd Ave Bldg A, Suite A01 & A02, Phoenix, AZ 85021-4185 | 2015-07-27 |
| 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.