ARIZONA STATE UNIVERSITY (NPI# 1255511465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255511465 |
Entity Type | Organization |
Organization Name | ARIZONA STATE UNIVERSITY |
Other Organization Name | ARIZONA STATE UNIVERSITY HEALTH SERVICES |
Practice Address |
4701 West Thunderbird Road University Center Building, Room 190 Glendale AZ 85306 |
Mailing Address |
Po Box 872104 Tempe AZ 85287-2104 |
Practice Telephone | 6025438019 |
Practice Fax Number | 6025438079 |
Mailing Telephone | 4809653346 |
Mailing Fax Number | 4809652269 |
Enumeration Date | 2007-11-06 |
Last Update Date | 2014-11-03 |
Authorized Official Name | DR. ALLAN MARKUS (PHYSICIAN/DIRECTOR) |
Authorized Official Telephone | 4809651145 |
Authorized Official Credential | M.D. |
Is Organization Subpart | Y |
Parent Organization Name | ARIZONA STATE UNIVERSITY |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 207Q00000X | Family Medicine | AZ | Allopathic & Osteopathic Physicians | |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AZ | Physician Assistants & Advanced Practice Nursing Providers |
Other Name | Type Code |
---|---|
Arizona State University Health Services | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396072682 | Arizona State University | Clinic/Center | 1555 N Bridalwreath St, Tempe, AZ 85281-1601 | 2009-11-09 |
1912187121 | Arizona State University | Family Medicine | 7332 E. Sun Devil Mall, Mesa, AZ 85212 | 2007-11-06 |
1164601811 | Arizona State University | Clinic/Center | 1124 N 3rd St, Phoenix, AZ 85004-1805 | 2007-10-30 |
1952338865 | Arizona State University | Audiologist | Coor Hall 2211, Tempe, AZ 85287-0102 | 2006-06-27 |
1467079020 | Arizona State University | Clinical Medical Laboratory | 1001 S Mcallister Ave, Tempe, AZ 85281-2115 | 2020-06-30 |
1063883924 | Arizona State University | Audiologist | 975 S. Myrtle Avenue, Coor Hall 2211, Tempe, AZ 85281 | 2015-10-16 |
1477959518 | Arizona State University | Non-Pharmacy Dispensing Site | 500 E Veterans Way, Tempe, AZ 85287-0001 | 2014-11-18 |
1821492455 | Arizona State University | Non-Pharmacy Dispensing Site | 500 E Veterans Way, Tempe, AZ 85287-0001 | 2014-10-10 |
1265798664 | Arizona State University | Clinic/Center | 500 N 3rd St, Phoenix, AZ 85004-2135 | 2012-04-10 |
1194058917 | Arizona State University | Clinic/Center | 2150 E Orange St, Tempe, AZ 85281-4814 | 2009-09-11 |
Entity Type | Entity Name | Entity Address |
---|---|---|
North Carolina Corporations | Arizona State University | 1475 N Scottsdale Rd, Scottsdale, AZ 85257 |
System for Award Management (SAM) Entities | ARIZONA STATE UNIVERSITY | 300 E University Dr Ste 410, Tempe, AZ 85281-2061 |
Colorado Business Entities | Arizona State University Foundation for A New American University | 300 E University Dr, Tempe, AZ 85281 |
Ohio Business Entities | ARIZONA STATE UNIVERSITY FOUNDATION FOR A NEW AMERICAN UNIVERSITY | 300 E. University Dr., Tempe, AZ 85281 |
Oklahoma Business Registrations | ARIZONA STATE UNIVERSITY FOUNDATION FOR A NEW AMERICAN UNIVERSITY | Po Box 2260, Tempe, AZ 85280-2260 |
Street Address |
4701 WEST THUNDERBIRD ROAD UNIVERSITY CENTER BUILDING, ROOM 190 |
City | GLENDALE |
State | AZ |
Zip Code | 85306 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548784648 | Michelle Weissgerber | Registered Nurse | 6640 W Maui Ln, Glendale, AZ 85306 | 2017-07-31 |
1427502947 | Az Interact LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6055 West Caribe Lane, Glendale, AZ 85306 | 2016-08-12 |
1649667635 | Richard Moreno Jr. | Physical Therapy Assistant | 6509 W Acapulco Ln, Glendale, AZ 85306 | 2015-04-17 |
1568863819 | Alternative Living for You | Assisted Living Facility | 5328 W. Tierra Buena Ln., Glendale, AZ 85306 | 2014-09-05 |
1649614561 | Matthew Brownell | Internal Medicine | 5555 W, Thunderbird, Banner Thunderbird Medical Center, Glendale, AZ 85306 | 2013-04-22 |
1366736266 | Miles Christenson | Speech-Language Pathologist | 14627 N 60th Ave, Glendale, AZ 85306 | 2011-06-08 |
1285928721 | Nathalie Tania Petein-alamshaw | Internal Medicine | 5555 W Thunderbird Road, Glendale, AZ 85306 | 2011-06-01 |
1134351869 | William J. Duff | Counselor | 5701 W. Talavi Boulevard, Suite 180, Phoenix, AZ 85306 | 2009-08-13 |
1538321369 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 5422 W. Thunderbird, Suite 8, Glendale, AZ 85306 | 2008-07-02 |
1316109143 | Cardiovascular Consultants, Ltd | Non-Pharmacy Dispensing Site | 5620 W. Thunderbird, Suite D3, Glendale, AZ 85306 | 2008-07-02 |
Find all providers in zip 85306 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770199481 | Steven Cleo Northern Jr. | Nurse Practitioner | 5820 W Greenway Rd Ste 124, Glendale, AZ 85306-3308 | 2020-09-17 |
1609493279 | Traci Marie Miramontes | Nurse Practitioner | 6001 W Northview Ave, Glendale, AZ 85301-1857 | 2020-06-30 |
1669097697 | Swazi Cromwell | Nurse Practitioner | 13408 N 53rd Ave, Glendale, AZ 85304-1378 | 2020-06-16 |
1922620590 | Bethany E Mainville | Nurse Practitioner | 8151 W Sierra Vista Dr, Glendale, AZ 85303-3217 | 2020-05-17 |
1184252678 | Revive Wellness and Rejuvenation LLC | Nurse Practitioner | 20229 N 67th Ave Ste C-a, Glendale, AZ 85308-6664 | 2020-03-30 |
1083247316 | Anna Lazzaro | Nurse Practitioner | 4760 W Ponderosa Ln, Glendale, AZ 85308-4872 | 2020-02-14 |
1760021422 | Judy Fong | Nurse Practitioner | 5220 W Dahlia Dr, Glendale, AZ 85304-1931 | 2019-12-29 |
1588207138 | Kristen Mitchell | Nurse Practitioner | 6922 W Kristal Way, Glendale, AZ 85308-5772 | 2019-10-25 |
1760038335 | Adrineh Kalantar Ohanian | Nurse Practitioner | 1139 E Lexington Dr, Glendale, CA 91206-3861 | 2019-08-09 |
1457904252 | Debra Goldman | Nurse Practitioner | 20325 N 51st Ave # 8, Glendale, AZ 85308-5674 | 2019-07-20 |
Find all providers in GLENDALE |
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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.