MEDICAL GROUP OF ARIZONA, LLC (NPI# 1366796773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366796773 |
| Entity Type | Organization |
| Organization Name | MEDICAL GROUP OF ARIZONA, LLC |
| Practice Address |
13430 N. Black Canyon Highway Suite 100 Phoenix AZ 85029-1310 |
| Mailing Address |
4616 N 51st Ave Suite 103 Phoenix AZ 85031-1720 |
| Practice Telephone | 6029439200 |
| Practice Fax Number | 6022163000 |
| Mailing Telephone | 4806868737 |
| Mailing Fax Number | 6022163000 |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |
| Authorized Official Name | DR. REGINALD M. SUTTON (SOLE MEMBER) |
| Authorized Official Telephone | 4806868737 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
29166 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
13430 N. BLACK CANYON HIGHWAY SUITE 100 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85029-1310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153799 | Haydee Bermudez | Counselor | 3301 North 33rd Ave., Phoenix, AZ 85029 | 2020-10-27 |
| 1871191221 | Covenant Home Health LLC | In Home Supportive Care | 11830 N. 19th Ave, Suite 101 Pendleton, Phoenix, AZ 85029 | 2020-10-16 |
| 1508406745 | Tailored 2 U Psychiatry, Pllc | Nurse Practitioner | 4150 W Peoria Avenue, Suite 116, Phoenix, AZ 85029 | 2020-01-15 |
| 1770125403 | Desert Gem Assisted Living Facility, LLC | Custodial Care Facility | 3236 W. Eugie Avenue, Phoenix, AZ 85029 | 2019-10-15 |
| 1588128623 | Anna Debbs | Counselor | 11221 North 28th Drive, Bldg E, Phoenix, AZ 85029 | 2019-01-23 |
| 1609360007 | Melissa Lynn Denton | Specialist/Technologist | 4014 W Paradise Dr, Phoenix, AZ 85029 | 2018-06-19 |
| 1275038713 | Jamilah Amirah | Behavioral Analyst | 11024 N 28th Dr Ste 110, Phoenix, AZ 85029 | 2018-03-27 |
| 1639687056 | Empower Home Care, LLC. | Home Health | 11225 N 28th Drive, Suite D115e, Phoenix, AZ 85029 | 2018-01-19 |
| 1467975698 | Samantha June Collett | Nurse Practitioner | 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 | 2017-07-19 |
| 1073966347 | Meka Joi Green | Social Worker | 11225 M 28th Dr, Suite C210, Phoenix, AZ 85029 | 2016-07-21 |
| Find all providers in zip 85029 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| 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 Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073148326 | Team Select Mobile Physicians Az LLC | Family Medicine | 2999 N 44th St Ste 110, Phoenix, AZ 85018-7247 | 2020-03-06 |
| 1851612329 | Lake Mi Mobile Doctors, P.C. | Family Medicine | 2345 E. Thomas Rd, Suite # 420, Phoenix, AZ 85016 | 2010-06-18 |
| 1265617013 | Shelly R Myers | Family Medicine | 4520 N 12th St, Suite #103, Phoenix, AZ 85014-4233 | 2007-12-28 |
| 1225236367 | Thomas J Cuomo Jr Md PC | Family Medicine | 13835 N Tatum Blvd # 9468, Phoenix, AZ 85032-5581 | 2007-07-10 |
| 1225132608 | Sona S Giknavorian | Family Medicine | 2345 E Thomas Rd Ste 420, Suite # 420, Phoenix, AZ 85016-7862 | 2006-09-07 |
| 1598702086 | Robin F Macdougall | Family Medicine | 4626 E. Shea Blvd, Suite C230, Phoenix, AZ 85028 | 2006-06-01 |
| 1205812757 | Thomas J Cuomo Jr | Family Medicine | 13835 N Tatum Blvd, 9615, Phoenix, AZ 85032-5581 | 2005-12-16 |
| 1710255088 | Mh7, LLC | Family Medicine | 4520 N 12th St, Suite 103, Phoenix, AZ 85014-4233 | 2011-12-01 |
| 1861624702 | John C. Lincoln, LLC | Family Medicine | 1668 W Glendale Ave, Suite 128, Phoenix, AZ 85021-8948 | 2009-08-11 |
| 1174764708 | Reginald Mortimer Sutton | Family Medicine | 4616 N 51st Ave, Suite 103, Phoenix, AZ 85031-1716 | 2009-03-11 |
| 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.