DR. KRISTA DEANN PELLICORE (NPI# 1235174731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235174731 |
| Entity Type | Individual |
| Full Name | DR. KRISTA DEANN PELLICORE |
| Credential | M.D. |
| Practice Address |
140 N Litchfield Rd Suite 200 Goodyear AZ 85338-1277 |
| Mailing Address |
2702 N 3rd St Suite 4020 Phoenix AZ 85004-1130 |
| Practice Telephone | 6022437277 |
| Practice Fax Number | 6023238048 |
| Mailing Telephone | 6022437277 |
| Mailing Fax Number | 6023233399 |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2015-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 48328 | AZ | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01057388A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS PROVIDER NUMBER | 000000305690 | 01 | |
| AZ | 857797 | 05 | |
| IN | 200447730 | 05 |
| Street Address |
140 N LITCHFIELD RD SUITE 200 |
| City | GOODYEAR |
| State | AZ |
| Zip Code | 85338-1277 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114545449 | Jacqueline Godinez Lopez | Dietitian, Registered | 140 N Litchfield Rd, Suite 106, Goodyear, AZ 85338-1226 | 2020-07-13 |
| 1477098432 | Phoenix Spine Surgeons, Ltd | Orthopaedic Surgery | 140 N Litchfield Rd, Suite 110, Goodyear, AZ 85338 | 2016-12-30 |
| 1891175188 | Phoenix Spine Goodyear Asc, LLC | Clinic/Center | 140 N Litchfield Rd, Suite 110, Goodyear, AZ 85338 | 2015-06-02 |
| 1629302229 | Debra Iglesias | Nurse Practitioner | 140 N Litchfield Rd, Suite 200, Goodyear, AZ 85338-1277 | 2009-09-29 |
| 1982859674 | Planned Parenthood Arizona | Clinic/Center | 140 N Litchfield Rd, Ste 100, Goodyear, AZ 85338-1277 | 2008-11-21 |
| 1871667014 | Arizona Center for Neurosurgery, Ltd | Physical Medicine & Rehabilitation | 140 N Litchfield Rd, Suite 110, Goodyear, AZ 85338-1277 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295226884 | Caroline Chang | Dentist | 15530 W Roosevelt St Ste E106, Goodyear, AZ 85338 | 2018-05-20 |
| 1609376714 | Rosanna Alvarez | Licensed Practical Nurse | 17432 W Elaine Dr, Goodyear, AZ 85338 | 2018-02-15 |
| 1023534419 | Jennifer Elizabeth Lawrence Dixon | Social Worker | 319 N Lichfield Rd, Suite 105, Goodyear, AZ 85338 | 2017-08-17 |
| 1346774916 | Vanessa Castillo | Specialist/Technologist | 18035 W. Yuma Rd, Goodyear, AZ 85338 | 2017-04-20 |
| 1386008076 | Hope Behavioral Health Residential Care | Substance Abuse Rehabilitation Facility | 15985 W.williams Street, Goodyear, AZ 85338 | 2016-04-08 |
| 1952760241 | Jeremy John Abdul-haqq | Dentist | 15661 W Roosevelt St Ste 102, Goodyear, AZ 85338 | 2016-02-16 |
| 1417206897 | Kelly Renee Filo | Occupational Therapy Assistant | 10189 S. Hacienda Dr., Goodyear, AZ 85338 | 2012-08-31 |
| 1194015545 | Nancy Ann Amore | Licensed Practical Nurse | 15578 W Yuma Road, Goodyear, AZ 85338 | 2011-04-19 |
| 1932409208 | Chung Counihan | Pharmacist | 9890 S Estrella Parkway, Goodyear, AZ 85338 | 2010-11-02 |
| 1053611327 | Traven Anderson | Pharmacist | 9890 South Estrella Parkway, Goodyear, AZ 85338 | 2010-11-02 |
| Find all providers in zip 85338 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093336794 | Nexx Level Healthcare | Family Medicine | 15664 W Devonshire Ave, Goodyear, AZ 85395-7773 | 2020-05-04 |
| 1043866593 | April Tatiana Vanderford | Family Medicine | 3050 N Litchfield Rd Ste 120, Goodyear, AZ 85395-7805 | 2019-08-12 |
| 1275853715 | Michael Raymond Brady | Family Medicine | 13471 W. Cornerstone Blvd, Goodyear, AZ 85395 | 2010-06-07 |
| 1437471711 | John Edward Manning Jr. | Family Medicine | 13591 W Roanoke Ave, Goodyear, AZ 85395-2254 | 2010-02-27 |
| 1174855159 | David Laurtiz Jensen | Family Medicine | 3090 N Litchfield Rd Ste 120, Goodyear, AZ 85395-9214 | 2010-02-02 |
| 1730318387 | Christina Michelle Martin | Family Medicine | 750 N Estrella Pkwy Ste 60, Goodyear, AZ 85338-9279 | 2009-07-03 |
| 1144483207 | Giuseppe Byron Torres | Family Medicine | 14445 W Mcdowell Rd, Ste A-104, Goodyear, AZ 85395 | 2008-07-08 |
| 1093858003 | Sun Valley Urgent Care | Family Medicine | 2910 N. Litchfield Road, Goodyear, AZ 85395 | 2007-02-15 |
| 1346312451 | John Robert Monroe | Family Medicine | 750 N Estrella Pkwy Ste 40, Goodyear, AZ 85338-9279 | 2006-11-14 |
| 1346354396 | Darrin Dean Scherer | Family Medicine | 3030 N Litchfield Rd, Suite 110, Goodyear, AZ 85395-7803 | 2006-08-18 |
| Find all providers in GOODYEAR | ||||
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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.