DESERET FAMILY PRACTICE, LTD. (NPI# 1215960638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215960638 |
| Entity Type | Organization |
| Organization Name | DESERET FAMILY PRACTICE, LTD. |
| Other Organization Name | DESERET FAMILY MEDICINE |
| Practice Address |
1425 S Greenfield Rd 101 Mesa AZ 85206-5529 |
| Practice Telephone | 4809813000 |
| Practice Fax Number | 4806545761 |
| Mailing Telephone | 4809813000 |
| Mailing Fax Number | 4806545761 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2017-07-31 |
| Authorized Official Name | DR. ROBERT J ALLEN (PRESIDENT) |
| Authorized Official Telephone | 4809813000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 4101 | AZ | Chiropractic Providers |
| N | 204D00000X | Neuromusculoskeletal Medicine & OMM | 006034 | AZ | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Deseret Family Medicine | Doing Business As Name - Organization |
| Street Address |
1425 S GREENFIELD RD 101 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-5529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568426518 | Center for Oupatient Imaging, L.L.C. | Clinic/Center | 1425 S Greenfield Rd, Suite 102, Mesa, AZ 85206-5505 | 2006-04-14 |
| 1669921524 | Corey Wayne Deberry-seguine | Physician Assistant | 1425 S Greenfield Rd, Suite #101, Mesa, AZ 85206-5529 | 2016-10-03 |
| 1265803092 | Daniel Ballard | Physician Assistant | 1425 S Greenfield Rd, Mesa, AZ 85206-5529 | 2015-10-20 |
| 1891109682 | Emily Hall | Dentist | 1425 S Greenfield Rd, Bldg 2, Ste 110, Mesa, AZ 85206-5529 | 2014-06-19 |
| 1053631309 | An Elegant Smile P.C. | Dentist | 1425 S Greenfield Rd, Bldg 2 Ste 110, Mesa, AZ 85206-5529 | 2010-06-09 |
| 1609105204 | Jonathan Natividad Jarvina | Internal Medicine | 1425 S Greenfield Rd, #101, Mesa, AZ 85206-5529 | 2009-12-10 |
| 1184630758 | Idenise Cabanas | Physician Assistant | 1425 S Greenfield Rd, 101, Mesa, AZ 85206-5529 | 2006-08-01 |
| 1538183413 | Dalenor R. Halls | Physician Assistant | 1425 S Greenfield Rd, 101, Mesa, AZ 85206-5529 | 2006-07-26 |
| 1972538569 | Robert J Allen | Family Medicine | 1425 S Greenfield Rd, 101, Mesa, AZ 85206-5529 | 2006-07-11 |
| 1194758524 | David J Farnsworth | Chiropractor | 1425 S Greenfield Rd, 101, Mesa, AZ 85206-5529 | 2006-07-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
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| 1558836270 | Cardiac Cath Lab of Mesa, LLC | Clinic/Center | 4555 E Inverness Ave Ste 1, Mesa, AZ 85206-4630 | 2018-10-09 |
| 1477095735 | Mckellips Internal Medicine Pllc | Clinic/Center | 3049 E Mckellips Rd Ste 5, Mesa, AZ 85213-3144 | 2016-11-17 |
| 1558365536 | Shannon Gray | Clinic/Center | 605 N Gilbert Rd, Mesa, AZ 85203-6629 | 2005-06-08 |
| 1033594247 | Banner School Based Clinic | Clinic/Center | 855 W 8th Ave, Mesa, AZ 85210-3401 | 2015-07-29 |
| 1407191216 | Banner Childrens Banner Health Clinic LLC | Clinic/Center | 1220 S Higley Rd Ste 101, Mesa, AZ 85206-4001 | 2012-12-05 |
| 1841573870 | Banner Physician Super Specialists Arizona LLC | Clinic/Center | 1432 S Dobson Rd, Mesa, AZ 85202-4768 | 2011-09-26 |
| 1639323447 | Banner Pediatric Specialists LLC | Clinic/Center | 1432 S Dobson Rd, Mesa, AZ 85202-4768 | 2008-11-06 |
| 1487814240 | Phoenix Children's Medical Group | Clinic/Center | 5131 E Southern Ave, Mesa, AZ 85206-2799 | 2008-06-13 |
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| 1659970242 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33300 N 32nd Ave, Phoenix, AZ 85085-8877 | 2020-10-23 |
| 1689273542 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33400 N 32nd Ave Fl 1, Phoenix, AZ 85085-8876 | 2020-10-21 |
| 1629676317 | Bethel Hills Integrated Healthcare | Clinic/Center | 13838 S 46th Pl Ste 300, Phoenix, AZ 85044-7804 | 2020-10-14 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| 1235745464 | Vasco Healthcare Inc | Clinic/Center | 2110 W 24th St Ste A, Yuma, AZ 85364-8878 | 2020-09-22 |
| 1265048490 | Vasco Healthcare Inc | Clinic/Center | 8952 E Desert Cove Ave Ste 204, Scottsdale, AZ 85260-6777 | 2020-09-22 |
| 1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
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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.