OMNI DERMATOLOGY ESTRELLA LLC (NPI# 1225570732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225570732 |
Entity Type | Organization |
Organization Name | OMNI DERMATOLOGY ESTRELLA LLC |
Practice Address |
9305 W Thomas Rd Ste 350 Phoenix AZ 85037-3328 |
Mailing Address |
4840 E Indian School Rd Ste 102 Phoenix AZ 85018-5500 |
Practice Telephone | 6234788000 |
Practice Fax Number | 6234788003 |
Mailing Telephone | 6029543919 |
Mailing Fax Number | 6029543670 |
Enumeration Date | 2016-11-15 |
Last Update Date | 2016-11-15 |
Authorized Official Name | DR. ANDREW JOSEPH RACETTE (PRESIDENT) |
Authorized Official Telephone | 6029543919 |
Authorized Official Credential | D.O. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | Other Service Providers |
Street Address |
9305 W THOMAS RD STE 350 |
City | PHOENIX |
State | AZ |
Zip Code | 85037-3328 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467457747 | Mystie L Johnson | Obstetrics & Gynecology | 9305 W Thomas Rd, Ste 155, Phoenix, AZ 85037-3328 | 2005-06-14 |
1295219624 | Samantha Albrecht | Nurse Practitioner | 9305 W Thomas Rd, Phoenix, AZ 85037-3328 | 2018-09-21 |
1326597444 | Vanessa Breguez Mitchell | Physician Assistant | 9305 W Thomas Rd, Suite 410, Phoenix, AZ 85037-3328 | 2016-09-30 |
1912353806 | Center for Orthopedic Research and Education, Inc | Durable Medical Equipment & Medical Supplies | 9305 W Thomas Rd, Suite 275, Phoenix, AZ 85037-3328 | 2016-05-10 |
1700270071 | Sarah Francis Debenedetto | Physical Therapist | 9305 W Thomas Rd, Suite 150, Phoenix, AZ 85037-3328 | 2015-03-25 |
1881088144 | Keith Butler | Physical Therapist | 9305 W Thomas Rd, Suite 150, Phoenix, AZ 85037-3328 | 2015-03-25 |
1366848814 | Tanner Jo Caughey | Physical Therapist | 9305 W Thomas Rd, Suite 150, Phoenix, AZ 85037-3328 | 2014-11-11 |
1720403397 | Caroline Seronde | Physical Therapy Assistant | 9305 W Thomas Rd, Ste 150, Phoenix, AZ 85037-3328 | 2014-02-19 |
1750702759 | Holly Hussey | Occupational Therapist | 9305 W Thomas Rd, Suite 150, Phoenix, AZ 85037-3328 | 2013-12-18 |
1962830471 | Center for Orthopedic Research and Education | Occupational Therapist | 9305 W Thomas Rd, Ste 275, Phoenix, AZ 85037-3328 | 2013-10-18 |
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1356969828 | Live Well Assisted Living LLC | Psychiatric Residential Treatment Facility | 9210 W Loow Bend Lane, Phoenix, AZ 85037 | 2020-07-10 |
1770126260 | Medical Management Systems, Inc. | Assisted Living Facility | 2209 N. Rascon Loop, Phoenix, AZ 85037 | 2019-10-28 |
1346800760 | Sonoran Sky Family Dentistry | Dentist | 9515 West Camelback Road, Suite #120, Phoenix, AZ 85037 | 2019-06-18 |
1578025136 | Jennifer Natasha Kunz | Nurse Practitioner | Cleanslate, 8410 W. Thomas Rd, Phoenix, AZ 85037 | 2019-04-03 |
1740751320 | Mariposa Phoenix Al Partners, Lp | Assisted Living Facility | 3100 N 91st Avenue, Phoenix, AZ 85037 | 2018-12-08 |
1417442799 | Prop Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9250 W Thomas Rd Ste 220, Phoenix, AZ 85037 | 2018-06-28 |
1922522242 | Tree of Life Mental Health Systems, LLC | Behavior Technician | 8400 W. Virginia, #1138, Phoenix, AZ 85037 | 2017-07-28 |
1720500465 | Moc Phoenix, LLC | Assisted Living Facility | 3000 N. 91st Avenue, Phoenix, AZ 85037 | 2017-07-14 |
1407385826 | Not Alone Home Care, LLC | In Home Supportive Care | 9422 W Palm Lane, Phoenix, AZ 85037 | 2017-06-08 |
1063953081 | Karla Soward | Radiologic Technologist | 2015 N Rascon Loop, Phoenix, AZ 85037 | 2017-03-09 |
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Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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---|---|---|---|---|
1902462179 | Physician Group of Arizona Inc | Specialist | 4801 E Washington St Ste 200, Phoenix, AZ 85034-2019 | 2019-05-14 |
1922517655 | Southwest Behavioral Health Services, Inc. | Specialist | 11221 N 28th Dr Bldg E, Phoenix, AZ 85029-5615 | 2017-09-26 |
1962936773 | Zoe Reed | Specialist | 20950 N 29th Ave, Suite 100, Phoenix, AZ 85027-3110 | 2017-04-18 |
1295289163 | Affiliated Therapy Services | Specialist | 4650 E Cotton Center Blvd Ste 155, Phoenix, AZ 85040-4803 | 2016-08-09 |
1285084400 | Jacqueline Kincer | Specialist | 4500 N 32nd St Ste 201d, Phoenix, AZ 85018-3397 | 2016-06-18 |
1750747218 | Hilary Caine | Specialist | 6228 W Molly Dr, Phoenix, AZ 85083-6525 | 2016-01-13 |
1659757268 | Armendariz Medical Associates LLC | Specialist | 3509 E Shea Blvd Ste 103, Phoenix, AZ 85028-3337 | 2015-08-05 |
1669877247 | Shawna Christofis | Specialist | 3940 E Goldfinch Gate Ln, Phoenix, AZ 85044-4513 | 2014-10-25 |
1396151890 | Michelle Rene' Reinhardt | Specialist | 11010 S Tomah St, Phoenix, AZ 85044-1914 | 2014-07-03 |
1518371863 | Stacy Hall Brink | Specialist | 4713 E Michigan Ave, Phoenix, AZ 85032-9517 | 2014-06-15 |
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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.