PROVIDENCE GENERAL MEDICINE (NPI# 1508180043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508180043 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE GENERAL MEDICINE |
| Practice Address |
1701 W Glendale Ave Phoenix AZ 85021-9701 |
| Practice Telephone | 6022469090 |
| Practice Fax Number | 6022469867 |
| Mailing Telephone | 6022469090 |
| Mailing Fax Number | 6022469867 |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |
| Authorized Official Name | MS. BLANCA MARQUEZ (MANAGER) |
| Authorized Official Telephone | 6022547077 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
AP3603 | AZ | Ambulatory Health Care Facilities |
| Street Address |
1701 W GLENDALE AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85021-9701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790840031 | Rex Eldon Brewster | Dentist | 1701 W Glendale Ave, Suite 4, Phoenix, AZ 85021 | 2006-12-27 |
| 1346683950 | Sonrisa Dental, LLC | Dentist | 1701 W Glendale Ave, Suite 1, Phoenix, AZ 85021-9701 | 2013-04-12 |
| 1740482694 | Ooli Orthodontics - Az, Phx, P.C. | Dentist | 1701 W Glendale Ave, Suite #3, Phoenix, AZ 85021-9701 | 2007-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173181 | Jill M Robinson | Social Worker | 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 | 2020-10-26 |
| 1528671013 | Sabrina Mcninch | Behavior Technician | 1200 W Dunlap Ave, Ste 100, Phoenix, AZ 85021 | 2020-08-25 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1841832664 | Madison Westby | Physical Therapist | 717 W Dunlap Ave # 100, Phoenix, AZ 85021 | 2019-10-14 |
| 1861967481 | Southwest Family Naturopathic Clinic Pllc | Naturopath | 1530 W Glendale Ave Suite 103, Phoenix, AZ 85021 | 2018-10-10 |
| 1184101461 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 8804 N 23rd Ave, Suite A01/a02, Phoenix, AZ 85021 | 2018-07-19 |
| 1568970150 | Alycia Ann Poloni | Occupational Therapist | 7129 N 23d Ave, Phoenix, AZ 85021 | 2018-01-17 |
| 1154839165 | Cyrus Professional Corporation | Dentist | 2401 W. Glendale Ave, Ste 102, Phoenix, AZ 85021 | 2018-01-12 |
| 1568980779 | Marla Jean Clay | Licensed Practical Nurse | 1717 W. Glendale Ave. Apt. 3011, Phoenix, AZ 85021 | 2017-09-07 |
| 1801325162 | Kaitlin King | Nurse Practitioner | 8824 N 9th Ave, Phoenix, AZ 85021 | 2017-06-08 |
| Find all providers in zip 85021 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629546130 | Josh Vella, M.d., Pllc | Clinic/Center | 3200 E Camelback Rd Ste 180, Phoenix, AZ 85018-2326 | 2018-11-02 |
| 1417433236 | Spectrum Medical Care Center | Clinic/Center | 52 E Monterey Way Ste A, Phoenix, AZ 85012-2628 | 2018-07-15 |
| 1063685824 | Carriker Eye Center, PC | Clinic/Center | 502 W Northview Ave, Phoenix, AZ 85021-8742 | 2008-04-11 |
| 1942429923 | No Appointment Md | Clinic/Center | 12235 N Cave Creek Rd., Suite 9, Phoenix, AZ 85022 | 2007-04-25 |
| 1699015446 | Podolak Chiropractic Center LLC | Clinic/Center | 4131 W Thunderbird Rd, Phoenix, AZ 85053-5341 | 2013-02-15 |
| 1871846055 | Az Pain Specialists, LLC | Clinic/Center | 668 N 44th St, Suite 100-w, Phoenix, AZ 85008-6506 | 2012-10-24 |
| 1639460025 | Phoenix Spine Consultants | Clinic/Center | 19841 N 27th Ave, Suite 300a, Phoenix, AZ 85027-4003 | 2011-04-20 |
| 1154651966 | Pediatric Endocrinology of Phoenix | Clinic/Center | 15600 N Black Canyon Hwy, Ste 102, Phoenix, AZ 85053-4055 | 2009-12-30 |
| 1770725913 | North Valley Head and Neck Surgery, LLC | Clinic/Center | 9327 N 3rd St, Suite 202, Phoenix, AZ 85020-2470 | 2009-04-02 |
| 1750523916 | Integrative Homeopathy, P.l.l.c. | Clinic/Center | 2001 W Camelback Rd, American Medical College of Homeopathy, Phoenix, AZ 85015-3466 | 2009-04-01 |
| 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.