SOUTHLAND GERIATRIC & PALLIATIVE CARE, LLC (NPI# 1447790985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447790985 |
| Entity Type | Organization |
| Organization Name | SOUTHLAND GERIATRIC & PALLIATIVE CARE, LLC |
| Practice Address |
4527 N 16th St Ste 104 Phoenix AZ 85016-5352 |
| Practice Telephone | 4808004800 |
| Practice Fax Number | 4806992914 |
| Mailing Telephone | 4808004800 |
| Mailing Fax Number | 4806992914 |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2020-06-08 |
| Authorized Official Name | OWEN OWENS (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 6028458000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 006329 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
4527 N 16TH ST STE 104 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-5352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902341431 | Nicolette Hawthorne | Nurse Practitioner | 4527 N 16th St, Phoenix, AZ 85016-5352 | 2016-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346760261 | Mallory Jody Murray | General Practice | 7000 E Mayo Blvd Ste 1020, Phoenix, AZ 85054-6152 | 2017-06-21 |
| 1265972269 | Md Assist, Inc. | General Practice | 7117 N 3rd St, Phoenix, AZ 85020-4902 | 2017-02-24 |
| 1861872756 | Keith King | General Practice | 6210 W Earll Dr, Phoenix, AZ 85033-5843 | 2015-06-04 |
| 1659767887 | Samuel Michal Anderson | General Practice | Po Box 31581, Phoenix, AZ 85046-1581 | 2015-04-14 |
| 1982090338 | Arizona Bleeding Disorders Health and Wellness Center | General Practice | 821 N 5th Ave, Phoenix, AZ 85003-1315 | 2015-04-13 |
| 1205238896 | Svelte LLC | General Practice | 2211 E Highland Ave Ste 215, Phoenix, AZ 85016-4834 | 2014-09-25 |
| 1760890131 | Emmitt Michael Thompson | General Practice | 822 West Earll Drive, Phoenix, AZ 85013 | 2014-07-29 |
| 1699104539 | Richard Fink | General Practice | 1037 E Baseline Rd, Phoenix, AZ 85042-6618 | 2013-11-01 |
| 1982031795 | Latino Care, LLC | General Practice | 3140 N 35th Ave, Suite 7, Phoenix, AZ 85017-5270 | 2013-10-11 |
| 1669730156 | Lifelink Inc | General Practice | 3039 W Peoria Ave Ste 102-125, Phoenix, AZ 85029-5212 | 2012-05-02 |
| 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.