FEP NCCH (NPI# 1124627815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124627815 |
| Entity Type | Organization |
| Organization Name | FEP NCCH |
| Practice Address |
8825 N 23rd Ave Ste 100 Phoenix AZ 85021-4148 |
| Practice Telephone | 8475712467 |
| Mailing Telephone | 8475712467 |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |
| Authorized Official Name | MARTIN FEDKNO (PRESIDENT) |
| Authorized Official Telephone | 8475712467 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
8825 N 23RD AVE STE 100 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85021-4148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173181 | Jill M Robinson | Social Worker | 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 | 2020-10-26 |
| 1528671013 | Sabrina Mcninch | Behavior Technician | 1200 W Dunlap Ave, Ste 100, Phoenix, AZ 85021 | 2020-08-25 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1841832664 | Madison Westby | Physical Therapist | 717 W Dunlap Ave # 100, Phoenix, AZ 85021 | 2019-10-14 |
| 1861967481 | Southwest Family Naturopathic Clinic Pllc | Naturopath | 1530 W Glendale Ave Suite 103, Phoenix, AZ 85021 | 2018-10-10 |
| 1184101461 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 8804 N 23rd Ave, Suite A01/a02, Phoenix, AZ 85021 | 2018-07-19 |
| 1568970150 | Alycia Ann Poloni | Occupational Therapist | 7129 N 23d Ave, Phoenix, AZ 85021 | 2018-01-17 |
| 1154839165 | Cyrus Professional Corporation | Dentist | 2401 W. Glendale Ave, Ste 102, Phoenix, AZ 85021 | 2018-01-12 |
| 1568980779 | Marla Jean Clay | Licensed Practical Nurse | 1717 W. Glendale Ave. Apt. 3011, Phoenix, AZ 85021 | 2017-09-07 |
| 1801325162 | Kaitlin King | Nurse Practitioner | 8824 N 9th Ave, Phoenix, AZ 85021 | 2017-06-08 |
| Find all providers in zip 85021 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669861423 | Arthur Barker | Emergency Medicine | 4205 W Reddie Loop, Phoenix, AZ 85083-1610 | 2015-01-16 |
| 1326481102 | Adrienne R Azurdia | Emergency Medicine | 4237 E Liberty Ln, Phoenix, AZ 85048-0537 | 2013-04-11 |
| 1538401930 | Hannah Malashock | Emergency Medicine | 129 W Coronado Rd, Phoenix, AZ 85003-1144 | 2013-03-23 |
| 1982977922 | Robert Ellis George | Emergency Medicine | 1011 W. Golden Ln., Phoenix, AZ 85021 | 2012-02-22 |
| 1588972889 | Glenn Richard Kunsman | Emergency Medicine | 3507 N Central Ave Ste 403, Phoenix, AZ 85012-2124 | 2010-09-21 |
| 1073849501 | Melissa Denny | Emergency Medicine | 4225 E Mcdowell Rd Apt 1039, Phoenix, AZ 85008-4418 | 2009-10-17 |
| 1700111689 | Rachel Levitan | Emergency Medicine | 2601 E. Roosevelt, Department of Emergency Medicine, Phoenix, AZ 85008 | 2009-10-09 |
| 1891029328 | Patrick Godwin | Emergency Medicine | 5045 E Oneida St, Phoenix, AZ 85044-3325 | 2009-09-30 |
| 1689802209 | Robert John Mintz | Emergency Medicine | 9225 N 3rd St Ste 307, Phoenix, AZ 85020-2466 | 2009-06-23 |
| 1902059652 | Mirela Ponduchi | Emergency Medicine | 1800 E Van Buren St., Phoenix, AZ 85006-3742 | 2008-10-28 |
| 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.