MOUNTAIN PARK HEALTH CENTER (NPI# 1386027852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386027852 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Practice Address |
17624 N 31st Ave Phoenix AZ 85053-1935 |
| Mailing Address |
3003 N Central Ave Ste 1600 Phoenix AZ 85012-2908 |
| Practice Telephone | 6022437277 |
| Mailing Telephone | 6023233345 |
| Mailing Fax Number | 6023233399 |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2018-03-13 |
| Authorized Official Name | DR. JOHN R SWAGERT (CEO) |
| Authorized Official Telephone | 6023233242 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OTC 0599 | AZ | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
| 1922105204 | Mountain Park Health Center | Clinic/Center | 140 N Litchfield Rd Ste 200&106, Goodyear, AZ 85338-1277 | 2006-09-20 |
| 1811490881 | Mountain Park Health Center | Clinic/Center | 303 E Baseline Rd, Phoenix, AZ 85042-6530 | 2018-03-15 |
| 1487037958 | Mountain Park Health Center | Clinic/Center | 5517 N 17th Ave, Phoenix, AZ 85015-2516 | 2015-07-02 |
| 1740663210 | Mountain Park Health Center | Clinic/Center | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2015-07-02 |
| 1669878567 | Mountain Park Health Center | Clinic/Center | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 | 2014-11-05 |
| 1467630012 | Mountain Park Health Center | Pharmacy | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2008-02-06 |
| 1578741120 | Mountain Park Health Center | Pharmacy | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2008-02-06 |
| 1740387018 | Mountain Park Health Center | Clinic/Center | 6601 West Thomas Road, Phoenix, AZ 85035-5700 | 2006-09-20 |
| 1376640656 | Mountain Park Health Center | Clinic/Center | 1840 E Broadway Rd, Tempe, AZ 85282-1614 | 2006-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOUNTAIN PARK HEALTH CENTER | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 |
| Street Address |
17624 N 31ST AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85053-1935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033328216 | Stacey Leigh Coats | Registered Nurse | 17624 N 31st Ave, Phoenix, AZ 85053-1935 | 2007-05-22 |
| 1528216462 | Elisabeth Ann Martin | Registered Nurse | 17624 N 31st Ave, Phoenix, AZ 85053-1935 | 2008-09-04 |
| 1316126691 | Janet E O'brien | Registered Nurse | 17624 N 31st Ave, Phoenix, AZ 85053-1935 | 2007-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871065615 | Valley Addiction & Mental Health Services LLC | Nurse Practitioner | 16845 N. 29th Ave, Ste 1-211, Phoenix, AZ 85053 | 2018-12-18 |
| 1417439100 | Amanda M Sherwin | Dietitian, Registered | 15640 N 28h Drive, Phoenix, AZ 85053 | 2018-08-30 |
| 1568970135 | Sage Counseling, Inc. | Community/Behavioral Health | 2734 W Bell Rd., #1385 & 1390, Phoenix, AZ 85053 | 2018-01-17 |
| 1366966434 | Penny L Reamer | Registered Nurse | 17624 N. 31st Ave., Phoenix, AZ 85053 | 2017-08-01 |
| 1043749302 | Jacob Stephen Lawrence | Occupational Therapy Assistant | 3116 W. Hartford Dr., Phoenix, AZ 85053 | 2017-06-08 |
| 1770022923 | Horizon Dental Group West Valley | Dentist | 4025 W. Bell Road, Suite 20, Phoenix, AZ 85053 | 2017-02-21 |
| 1235594938 | Linda Thi Trinh | Optometrist | 16020 North 35th Ave Suite #2, Phoenix, AZ 85053 | 2015-12-22 |
| 1003230301 | Continuum Group West, LLC. | Clinic/Center | 3710 W Greenway Rd, Suite 104, Phoenix, AZ 85053 | 2014-02-07 |
| 1831539410 | Michelle Lea Byers | Nurse Practitioner | 17624 North 31st Ave, Phoenix, AZ 85053 | 2013-06-27 |
| 1437446580 | Candace Faith Gershkovich | Dentist | 4235 W. Thunderbird Rd, Phoenix, AZ 85053 | 2011-07-08 |
| Find all providers in zip 85053 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194207878 | Valle Del Sol, Inc. | Clinic/Center | 1510 S 19th Dr, Phoenix, AZ 85009-6540 | 2018-08-30 |
| 1578059168 | Native Health | Clinic/Center | 6850 W Indian School Rd Ste Nh1, Phoenix, AZ 85033-3249 | 2018-07-06 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1346755295 | Circle The City | Clinic/Center | 210 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
| 1437607389 | Neighborhood Outreach Access To Health | Clinic/Center | 20440 N 27th Ave Ste 450, Phoenix, AZ 85027-3240 | 2016-09-20 |
| 1972907129 | Neighborhood Outreach Access To Health | Clinic/Center | 16251 N Cave Creek Rd, Phoenix, AZ 85032-2976 | 2014-10-17 |
| 1982830410 | Native Health | Clinic/Center | 2423 W Dunlap Ave Ste 140, Phoenix, AZ 85021-5818 | 2009-06-10 |
| 1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
| 1770196016 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 106 N. Rose Street, Phoenix, OR 97535 | 2020-08-26 |
| 1164055596 | Circle The City | Clinic/Center | 3522 N 3rd Ave, Phoenix, AZ 85013-3903 | 2020-02-13 |
| 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.