PHOENIX ID LLC (NPI# 1205027646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205027646 |
| Entity Type | Organization |
| Organization Name | PHOENIX ID LLC |
| Practice Address |
340 E Palm Ln Ste 100 Phoenix AZ 85004-4528 |
| Mailing Address |
3303 S Lindsay Rd Ste 123 Gilbert AZ 85297-2100 |
| Practice Telephone | 6022541136 |
| Practice Fax Number | 6022721720 |
| Mailing Telephone | 4808219339 |
| Mailing Fax Number | 4808219555 |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2008-10-09 |
| Authorized Official Name | JACOB OOMMEN (OWNER) |
| Authorized Official Telephone | 4809077786 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
37316 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
340 E PALM LN STE 100 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85004-4528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396360749 | Ulivvo Inc. | Nurse Practitioner | 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 | 2020-06-11 |
| 1508325929 | Ican America | Clinic/Center | Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 | 2019-03-15 |
| 1770064107 | Edward Jude Stein | Pharmacist | Two Renaissance Square, 40 N Central Ave, Suite 780, Ihs Clinical Support Center, Phoenix, AZ 85004 | 2018-08-23 |
| 1740775303 | Alexander L. Shaw | Dentist | 201 N Central Ave. #1490, Phoenix, AZ 85004 | 2018-06-26 |
| 1497267868 | Michael Dimoff | Registered Nurse | 1850 N. Central Ave, Ste 1600, Phoenix, AZ 85004 | 2017-10-25 |
| 1093231433 | Ezequiel Bautista | Music Therapist | 2702 N 3rd Street, Suite 1000, Phoenix, AZ 85004 | 2017-08-17 |
| 1841742442 | Stacy Maahs | Nurse Practitioner | 500 N 3rd St Ste 155, Phoenix, AZ 85004 | 2016-10-29 |
| 1538537246 | Jessica Lindsay Karlson | Pharmacist | 2302 N Central Ave Ste 7, Phoenix, AZ 85004 | 2015-09-11 |
| 1689059883 | Yvette's Hope Foundation | Home Health | 40 N. Central Ave. Ste. 1400, Phoenix, AZ 85004 | 2015-07-29 |
| 1881082790 | Patricia Russell | Specialist/Technologist | 60 E. Vernon Ave, Arcadia Therapy Services, Phoenix, AZ 85004 | 2014-12-30 |
| Find all providers in zip 85004 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942695978 | Odero Consultants | Internal Medicine | 7000 N 16th St Ste 120, Phoenix, AZ 85020-5524 | 2015-04-07 |
| 1417129958 | Victor N. Gan | Internal Medicine | 1526 W Wilshire Dr, Phoenix, AZ 85007-1216 | 2008-03-25 |
| 1285839795 | Madhuri Segireddy | Internal Medicine | 340 E Palm Lane, A260, Phoenix, AZ 85004 | 2007-06-15 |
| 1356553986 | Desert Valley Infectious Disease Physicians | Internal Medicine | 233 W Lamar Rd, Phoenix, AZ 85013-1219 | 2007-05-04 |
| 1518096270 | Minghsun Liu | Internal Medicine | 11811 N Tatum Blvd Ste 1075, Phoenix, AZ 85028-1661 | 2007-03-05 |
| 1477664605 | Jones O Kumi M D P C | Internal Medicine | 2610 N 3rd St Ste A, Phoenix, AZ 85004-1156 | 2006-08-31 |
| 1790737138 | Patrick Aidan Murphy | Internal Medicine | 57 Blenheim Farm Ln, Phoenix, MD 21131-2136 | 2006-05-16 |
| 1396703757 | Daniel Marino | Internal Medicine | 128 W Marlette Ave, Phoenix, AZ 85013-1524 | 2006-05-03 |
| 1912973041 | Michael J. Gehman | Internal Medicine | 2700 N 3rd St Ste 3045, Phoenix, AZ 85004-4627 | 2006-02-28 |
| 1447241369 | Leslie Bruce Robinson | Internal Medicine | 19841 N 27th Ave Ste 403, Phoenix, AZ 85027-4007 | 2005-10-31 |
| 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.