TAG MEDICAL & STAFFING (NPI# 1558927921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558927921 |
| Entity Type | Organization |
| Organization Name | TAG MEDICAL & STAFFING |
| Practice Address |
2601 N 3rd St Ste 106 Phoenix AZ 85004-1144 |
| Mailing Address |
2371 E Azalea Dr Chandler AZ 85286-2365 |
| Practice Telephone | 2549318298 |
| Practice Fax Number | 6022488006 |
| Mailing Telephone | 2549318298 |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2019-05-11 |
| Authorized Official Name | MR. MATTHEW CLARK (CEO) |
| Authorized Official Telephone | 2549318298 |
| Authorized Official Credential | PHYSICIAN ASSIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCCPA | 1035995 | 01 | |
| AZ | STATE LICENSE | 2124 | 01 |
| Street Address |
2601 N 3RD ST STE 106 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85004-1144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164905535 | Clark Medical, Pllc | Family Medicine | 2601 N 3rd St Ste 106, Phoenix, AZ 85004-1144 | 2018-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396360749 | Ulivvo Inc. | Nurse Practitioner | 141 E Palm Lane, Suite 206, Phoenix, AZ 85004 | 2020-06-11 |
| 1508325929 | Ican America | Clinic/Center | Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 | 2019-03-15 |
| 1770064107 | Edward Jude Stein | Pharmacist | Two Renaissance Square, 40 N Central Ave, Suite 780, Ihs Clinical Support Center, Phoenix, AZ 85004 | 2018-08-23 |
| 1740775303 | Alexander L. Shaw | Dentist | 201 N Central Ave. #1490, Phoenix, AZ 85004 | 2018-06-26 |
| 1497267868 | Michael Dimoff | Registered Nurse | 1850 N. Central Ave, Ste 1600, Phoenix, AZ 85004 | 2017-10-25 |
| 1093231433 | Ezequiel Bautista | Music Therapist | 2702 N 3rd Street, Suite 1000, Phoenix, AZ 85004 | 2017-08-17 |
| 1841742442 | Stacy Maahs | Nurse Practitioner | 500 N 3rd St Ste 155, Phoenix, AZ 85004 | 2016-10-29 |
| 1538537246 | Jessica Lindsay Karlson | Pharmacist | 2302 N Central Ave Ste 7, Phoenix, AZ 85004 | 2015-09-11 |
| 1689059883 | Yvette's Hope Foundation | Home Health | 40 N. Central Ave. Ste. 1400, Phoenix, AZ 85004 | 2015-07-29 |
| 1881082790 | Patricia Russell | Specialist/Technologist | 60 E. Vernon Ave, Arcadia Therapy Services, Phoenix, AZ 85004 | 2014-12-30 |
| Find all providers in zip 85004 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1659848208 | Pacific Dental Services Foundation | Physician Assistant | 4559 E. Bell Road, Ste 106, Phoenix, AZ 85032 | 2018-10-31 |
| 1124502372 | Amanda Rose Jones | Physician Assistant | 36427 N 14th St, Phoenix, AZ 85086-7506 | 2018-09-23 |
| 1639681745 | Martha Lopez | Physician Assistant | 7010 E Chauncey Ln Ste 210, Phoenix, AZ 85054-3115 | 2017-10-30 |
| 1386153674 | Emily Meredith Eoff | Physician Assistant | 301 W Pasadena Ave Apt 4, Phoenix, AZ 85013-2342 | 2017-09-29 |
| 1659890754 | Greg Horn | Physician Assistant | 20333 N 19th Ave Ste 230, Phoenix, AZ 85027-9901 | 2017-09-11 |
| 1619407269 | Integrative Natural Medicine | Physician Assistant | 2025 E Campbell Ave, #259, Phoenix, AZ 85016-8501 | 2017-06-15 |
| 1174996870 | Jyoti Sharma | Physician Assistant | 13838 S 46th Pl Ste 120, Phoenix, AZ 85044-7801 | 2015-11-04 |
| 1487025086 | Shaye Harrel | Physician Assistant | 9305 W Thomas Rd Ste 478, Phoenix, AZ 85037-3375 | 2015-10-08 |
| 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.