PHOENIX CHILDREN'S HOSPITAL (NPI# 1457402364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457402364 |
| Entity Type | Organization |
| Organization Name | PHOENIX CHILDREN'S HOSPITAL |
| Other Organization Name | PHOENIX CHILDREN'S HOSPITAL - DIALYSIS CENTER |
| Practice Address |
1920 E Cambridge Ave Ste 102 Phoenix AZ 85006-1459 |
| Mailing Address |
3200 E Camelback Rd Ste 250 Phoenix AZ 85018-2311 |
| Practice Telephone | 6029333220 |
| Practice Fax Number | 6029330502 |
| Mailing Telephone | 6029331815 |
| Mailing Fax Number | 6029331820 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2019-07-09 |
| Authorized Official Name | RENEE CLARKE (VP, MANAGED CARE) |
| Authorized Official Telephone | 6029331802 |
| Is Organization Subpart | Y |
| Parent Organization Name | PHOENIX CHILDREN'S HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
OTC 3741 | AZ | Ambulatory Health Care Facilities |
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
MED2169 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AZ DEPT OF HEALTH SERVICES | MED2169 | 01 |
| Other Name | Type Code |
|---|---|
| Phoenix Children's Hospital - Dialysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023475506 | Phoenix Children's Hospital | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2016-01-28 |
| 1376944298 | Phoenix Children's Hospital | Clinic/Center | 3420 S Mercy Rd, Ste 121, Gilbert, AZ 85297-0419 | 2014-09-10 |
| 1841586773 | Phoenix Children's Hospital | Pharmacy | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2011-06-20 |
| 1598059172 | Phoenix Children's Hospital | Pediatrics | 3333 E Van Buren St, Phoenix, AZ 85008-6812 | 2011-06-01 |
| 1295028587 | Phoenix Children's Hospital | Pediatrics | 3333 E Van Buren St, Phoenix, AZ 85008-6812 | 2011-05-19 |
| 1386749836 | Phoenix Children's Hospital | Pharmacy | 1919 E Thomas Rd, Bldg B, Phoenix, AZ 85016-7710 | 2006-09-13 |
| 1922112044 | Phoenix Children's Hospital | Pediatrics | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2006-08-18 |
| 1760480503 | Phoenix Children's Hospital | General Acute Care Hospital | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 | 2005-07-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHOENIX CHILDREN'S HOSPITAL, INC. | 1919 E Thomas Rd, Phoenix, AZ 85016-7710 |
| Street Address |
1920 E CAMBRIDGE AVE STE 102 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85006-1459 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285630657 | Elisabet Prieto | Nurse Practitioner | 1920 E Cambridge Ave, Suite 301, Phoenix, AZ 85006-1459 | 2005-06-22 |
| 1396208625 | Nicole Dion Santonastaso | Dietitian, Registered | 1920 E Cambridge Ave, Phoenix, AZ 85006-1459 | 2019-04-12 |
| 1518486216 | Brianna Pruniski | Genetic Counselor, MS | 1920 E Cambridge Ave, Rosenberg Children's Medical Plaza, Suite 304, Phoenix, AZ 85006 | 2017-09-13 |
| 1063942639 | Allison Sayer | Audiologist | 1920 E Cambridge Ave, Phoenix, AZ 85006-1459 | 2017-06-15 |
| 1578969739 | Ashley Ortiz | Physician Assistant | 1920 E Cambridge Ave, Ste 302, Phoenix, AZ 85006-1459 | 2014-11-14 |
| 1932412152 | Andrea Marie Darosa | Dietitian, Registered | 1920 E Cambridge Ave, Suite 301, Phoenix, AZ 85006-1459 | 2010-07-16 |
| 1689986002 | Sheena Sharma | Pediatrics | 1920 E Cambridge Ave, 200, Phoenix, AZ 85006-1459 | 2010-07-14 |
| 1326363318 | Andrea Anne Ramirez | Pediatrics | 1920 E Cambridge Ave, Suite 200, Phoenix, AZ 85006-1459 | 2010-04-01 |
| 1669590543 | Mark Steven Molitor Jr. | Surgery | 1920 E Cambridge Ave, Suite #201, Phoenix, AZ 85006-1459 | 2007-03-27 |
| 1336264944 | Cranial Technologies Inc | Prosthetic/Orthotic Supplier | 1920 E Cambridge Ave, Rosenberg Pl, Bdg E, Suite 205, Phoenix, AZ 85006-1459 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356949929 | Teresa Louise Cox | Pharmacist | 1800 E Van Buren St., St. Luke's Behavioral Health, Phoenix, AZ 85006 | 2020-10-15 |
| 1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
| 1023638582 | Supraja Prakash | Genetic Counselor, MS | 1920 E Cambridge Ave., Rosenberg Bldg., Suite 304, Phoenix, AZ 85006 | 2020-04-24 |
| 1760017099 | Phoenix Medical Psychiatric Hospital, LLC | Psychiatric Hospital | 1346 Mcdowell Road, Phoenix, AZ 85006 | 2020-03-06 |
| 1265093108 | Zulianna Ibrahim | Student in an Organized Health Care Education/Training Program | Banner University Medical Center Phoenix Family Medicin, 1300 N. 12th Street Suite 605, Phoenix, AZ 85006 | 2019-06-21 |
| 1306318340 | Leah Margaret Hillier | Family Medicine | 1300 N 12th St - Suite 500, Phoenix, AZ 85006 | 2018-12-31 |
| 1477032357 | Joann Moskop | Chiropractor | 2719 N Greenfield Rd., Phoenix, AZ 85006 | 2018-08-10 |
| 1619464468 | Ana Maria Lara | Naturopath | 926 E Mcdowell Rd Ste 204, Phoenix, AZ 85006 | 2018-04-17 |
| 1194221770 | Nisha Bharat Patel | Student in an Organized Health Care Education/Training Program | Edwards Medical Plaza Suite 320, 1300 North 12th Street, Phoenix, AZ 85006 | 2018-04-03 |
| 1710486352 | Julia Cyr | Registered Nurse | 1008 E Mcdowell Rd Unit A, Phoenix, AZ 85006 | 2018-02-09 |
| Find all providers in zip 85006 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649730953 | Scottsdale Kidney Center LLC | Clinic/Center | 6970 E Chauncey Ln Ste 130, Phoenix, AZ 85054-5159 | 2019-03-22 |
| 1932688256 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 926 E Mcdowell Rd Ste 100, Phoenix, AZ 85006-2503 | 2018-08-08 |
| 1982152484 | Bio-medical Applications of Arizona, LLC | Clinic/Center | 4901 W Mcdowell Rd Ste 120, Phoenix, AZ 85035-4160 | 2016-09-14 |
| 1528442779 | Bio-medical Applications of Arizona, LLC | Clinic/Center | 16605 N 28th Ave Ste 100, Phoenix, AZ 85053-7551 | 2015-07-17 |
| 1295070761 | Calaveras Dialysis LLC | Clinic/Center | 5115 E Thomas Rd, Ste 115, Phoenix, AZ 85018-7914 | 2012-12-10 |
| 1801050604 | Southwest Kidney-davita Dialysis Partners LLC | Clinic/Center | 3540 E Baseline Rd Ste 110, Phoenix, AZ 85042-9628 | 2008-07-11 |
| 1770758526 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 4845 W Mcdowell Rd, Ste 10a, 20a, 30a, Phoenix, AZ 85035-4076 | 2008-04-23 |
| 1891897211 | Bio-medical Applications of Arizona, LLC | Clinic/Center | 1957 W Dunlap Ave Ste 6c, Phoenix, AZ 85021-2985 | 2006-09-05 |
| 1053423954 | Bio-medical Applications of Arizona LLC | Clinic/Center | 3421 N 7th Ave, Phoenix, AZ 85013-3635 | 2006-08-31 |
| 1477665289 | Renal Dimensions, LLC | Clinic/Center | 15930 S 48th St, Suite 100, Phoenix, AZ 85048-0903 | 2006-08-31 |
| 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.