EAST MESA FAMILY DOCTORS PLLC (NPI# 1508310665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508310665 |
| Entity Type | Organization |
| Organization Name | EAST MESA FAMILY DOCTORS PLLC |
| Other Organization Name | MEDICAL MALL OF ARIZONA FAMILY PRACTICE PLLC |
| Practice Address |
8035 E Brown Rd Bldg 4 Mesa AZ 85207 |
| Mailing Address |
8035 E Brown Rd Bldg 4 Mesa AZ 85210 |
| Practice Telephone | 4809990049 |
| Practice Fax Number | 8669188525 |
| Mailing Telephone | 4809990049 |
| Mailing Fax Number | 8669188525 |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2018-05-25 |
| Authorized Official Name | MRS. STACY MICKEY (MEDICAL PROVIDER) |
| Authorized Official Telephone | 4809990049 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | AZ | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Medical Mall of Arizona Family Practice PLLC | Former Legal Business Name - Organization |
| Street Address |
8035 E BROWN RD BLDG 4 |
| City | MESA |
| State | AZ |
| Zip Code | 85207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760449490 | Stacy Deann Veldhuizen Mickey | Family Medicine | 8035 E Brown Rd, Bldg 4, Mesa, AZ 85207 | 2006-04-27 |
| 1609486216 | Heritage Village Bldg1 LLC | Alzheimer Center (Dementia Center) | 8035 E Brown Rd, Mesa, AZ 85207-3901 | 2020-08-07 |
| 1790395309 | Heritage Village Bldg9 LLC | Assisted Living Facility | 8035 E Brown Rd, Mesa, AZ 85207-3901 | 2020-08-07 |
| 1467962506 | Heritage Village Bldg5, LLC | Assisted Living Facility | 8035 E Brown Rd, Mesa, AZ 85207-3901 | 2017-10-03 |
| 1821508961 | Heritage Village Bldg3, LLC | Assisted Living Facility | 8035 E Brown Rd, Mesa, AZ 85207-3901 | 2017-10-03 |
| 1922518067 | Heritage Village Bldg2, LLC | Assisted Living Facility | 8035 E Brown Rd, Mesa, AZ 85207-3901 | 2017-10-03 |
| 1811407950 | Heritage Village Bldg6, LLC | Assisted Living Facility | 8035 E Brown Rd, Mesa, AZ 85207-3901 | 2017-10-03 |
| 1235675703 | Samuel Hulsey | Pharmacist | 8035 E Brown Rd, Bldg 4, Suite-c, Mesa, AZ 85207-3901 | 2017-01-09 |
| 1982152732 | Freedom Pharmacy of Arizona At Red Mountain LLC | Pharmacy | 8035 E Brown Rd, Bldg 4, Ste C, Mesa, AZ 85207-3901 | 2016-09-21 |
| 1740637651 | Heritage Village 3 LLC | Assisted Living Facility | 8035 E Brown Rd, Bldg#3, Mesa, AZ 85207-3901 | 2016-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790241743 | Sharin Lane | Physical Therapist | Spooner North Mesa, PC, 6824 E Brown Rd # 102, Mesa, AZ 85207 | 2019-02-14 |
| 1154898435 | Phoenix Physician Group, LLC | Emergency Medicine | 3430 N. Mountain Ridge, Unit 14, Mesa, AZ 85207 | 2018-10-25 |
| 1467970939 | Kerry Mae Kenley | Specialist/Technologist | 7556 E. Laurel St, Mesa, AZ 85207 | 2017-09-05 |
| 1053709287 | Barbara Bowen | Speech-Language Pathologist | 8433 E. Leland St., Mesa, AZ 85207 | 2014-12-22 |
| 1043561046 | Joseph Allen Kempton | Physical Therapist | 844 N. Ellsworth Rd, Mesa, AZ 85207 | 2012-10-01 |
| 1629327556 | Odyssey Services Corp. | Community/Behavioral Health | 8947 East Quill Street, Mesa, AZ 85207 | 2012-09-06 |
| 1962729160 | Chao Li | Dermatology | 6832 E Brown Rd, Mesa, AZ 85207 | 2010-04-27 |
| 1366670929 | Trevor Lee Caffall | Dentist | 6812 E. Brown Rd., Ste 102, Mesa, AZ 85207 | 2009-06-22 |
| 1396928073 | Dht Hand Therapy Limited Partnership | Occupational Therapist | 7165 E University Dr Ste 143, Mesa, AZ 85207 | 2007-12-17 |
| 1184794075 | Karen L Thomas Pllc | Nurse Practitioner | 3902 N. Stone Gully Cricle, Mesa, AZ 85207 | 2006-11-08 |
| Find all providers in zip 85207 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884065 | Miranda Gamgah Njante | Family Medicine | 10445 E Pivitol Ave, Mesa, AZ 85212-8037 | 2020-09-02 |
| 1457987679 | Az Med 4u | Family Medicine | 1136 E Harmony Ave Ste 101, Mesa, AZ 85204-5844 | 2020-03-19 |
| 1619500089 | Elizabeth Lapioli | Family Medicine | 5422 S St Claire, Mesa, AZ 85212-5420 | 2020-02-13 |
| 1003448952 | M.g.t Rn LLC | Family Medicine | 7117 E Peralta Cir, Mesa, AZ 85212-9825 | 2020-02-09 |
| 1144793126 | Health and Wellness Clinic LLC | Family Medicine | 1155 S Country Club Dr, Mesa, AZ 85210-4615 | 2019-01-02 |
| 1013487800 | Akos Live | Family Medicine | 1902 W. Main Street, Mesa, AZ 85201 | 2018-12-05 |
| 1447725189 | Adam Craig Turner | Family Medicine | 925 N Nina Dr, Mesa, AZ 85201-3935 | 2018-10-09 |
| 1235620170 | Stephanie Deborah Kotsur | Family Medicine | 7334 E Plata Ave, Mesa, AZ 85212-9754 | 2018-05-26 |
| 1902308042 | Andrew Jason Wood | Family Medicine | 10902 E Sunland Ave, Mesa, AZ 85208-3938 | 2018-03-05 |
| 1871002683 | Verve Wellness Center, LLC. | Family Medicine | 4838 E Baseline Rd Ste 110, Mesa, AZ 85206-4674 | 2017-09-25 |
| Find all providers in MESA | ||||
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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.