MOUNTAIN PARK HEALTH CENTER (NPI# 1740387018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1740387018 |
Entity Type | Organization |
Organization Name | MOUNTAIN PARK HEALTH CENTER |
Practice Address |
6601 West Thomas Road Phoenix AZ 85035-5700 |
Mailing Address |
3003 N Central Ave Ste 1600 Phoenix AZ 85012-2908 |
Practice Telephone | 6022437277 |
Practice Fax Number | 6232479742 |
Mailing Telephone | 6023233407 |
Mailing Fax Number | 6023233496 |
Enumeration Date | 2006-09-20 |
Last Update Date | 2018-03-12 |
Authorized Official Name | DR. JOHN R SWAGERT (PRESIDENT /CEO) |
Authorized Official Telephone | 6023233344 |
Authorized Official Credential | MD |
Is Organization Subpart | Y |
Parent Organization Name | MOUNTAIN PARK HEALTH CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OTC 3035 | AZ | Ambulatory Health Care Facilities |
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 102577 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
1922105204 | Mountain Park Health Center | Clinic/Center | 140 N Litchfield Rd Ste 200&106, Goodyear, AZ 85338-1277 | 2006-09-20 |
1811490881 | Mountain Park Health Center | Clinic/Center | 303 E Baseline Rd, Phoenix, AZ 85042-6530 | 2018-03-15 |
1487037958 | Mountain Park Health Center | Clinic/Center | 5517 N 17th Ave, Phoenix, AZ 85015-2516 | 2015-07-02 |
1386027852 | Mountain Park Health Center | Clinic/Center | 17624 N 31st Ave, Phoenix, AZ 85053-1935 | 2015-07-02 |
1740663210 | Mountain Park Health Center | Clinic/Center | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2015-07-02 |
1669878567 | Mountain Park Health Center | Clinic/Center | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 | 2014-11-05 |
1467630012 | Mountain Park Health Center | Pharmacy | 635 E Baseline Rd, Phoenix, AZ 85042-6551 | 2008-02-06 |
1578741120 | Mountain Park Health Center | Pharmacy | 6601 W Thomas Rd, Phoenix, AZ 85033-5700 | 2008-02-06 |
1376640656 | Mountain Park Health Center | Clinic/Center | 1840 E Broadway Rd, Tempe, AZ 85282-1614 | 2006-09-20 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MOUNTAIN PARK HEALTH CENTER | 3003 N Central Ave Ste 1600, Phoenix, AZ 85012-2908 |
Street Address |
6601 WEST THOMAS ROAD |
City | PHOENIX |
State | AZ |
Zip Code | 85035-5700 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215931985 | John Morin Harpenau | Obstetrics & Gynecology | 6601 West Thomas Road, Phoenix, AZ 85033 | 2005-06-09 |
1083978274 | Chisomnazu Winifred Iweha-ononye | Nurse Practitioner | 6601 West Thomas Road, Phoenix, AZ 85033 | 2012-07-02 |
1649549635 | Chen-pei Hung | Nurse Practitioner | 6601 West Thomas Road, Phoenix, AZ 85033 | 2011-12-20 |
1174808315 | Stan Kudish | Pharmacist | 6601 West Thomas Road, Phoenix, AZ 85033 | 2011-10-19 |
1578841342 | Cristina Yturralde | Counselor | 6601 West Thomas Road, Phoenix, AZ 85033 | 2011-07-28 |
1619282613 | Joshua C Rubin | Psychologist | 6601 West Thomas Road, Phoenix, AZ 85035-5700 | 2010-08-13 |
1568783314 | Tritia Maria Pusateri | Pediatrics | 6601 West Thomas Road, Phoenix, AZ 85033-5700 | 2010-06-16 |
1053532986 | Laura Elena Arce-gomez | Family Medicine | 6601 West Thomas Road, Phoenix, AZ 85033 | 2007-05-01 |
1710049150 | Fernando Vazquez | Pediatrics | 6601 West Thomas Road, Phoenix, AZ 85033 | 2006-12-14 |
1649294760 | Ugonna Kem Woods | Pediatrics | 6601 West Thomas Road, Phoenix, AZ 85033 | 2006-07-26 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912420621 | Safe Run Non Emergency Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 7205 W Mcdowell Rd, Apt 1073, Phoenix, AZ 85035 | 2017-07-25 |
1710435581 | Aimee Uwimana | Nurse Practitioner | 5030 W. Mcdowell Rd. Ste. 16, Phoenix, AZ 85035 | 2016-09-21 |
1528427317 | Akdhc, LLC | Internal Medicine | 4901 W Mcdowell Rd, Phoenix, AZ 85035 | 2016-02-22 |
1285921544 | Tasnim Khalife | Family Medicine | 2303 N. 75th Ave., Phoenix, AZ 85035 | 2011-07-06 |
1528210192 | Scott Alan Ulrick | Chiropractor | 5120 W. Mcdowell Rd, Phoenix, AZ 85035 | 2008-10-15 |
1467627331 | Robert Anthony Bembenek | Chiropractor | 5030 W Mcdowell Suite 10, Phx, AZ 85035 | 2008-04-23 |
1164569935 | Roy Song | Dentist | 1820 N 75th Ave, Suite 112, Phoenix, AZ 85035 | 2007-01-31 |
1659418994 | Western Dental of Arizona, Inc. | Dentist | 1820 N. 75th Ave., Suite #112, Phoenix, AZ 85035 | 2007-01-30 |
1982774824 | Nationwide Vision Center, LLC | Technician/Technologist | 1820 North 75th Avenue, Suite 102, Phoenix, AZ 85035 | 2006-11-08 |
1396748976 | Kris Morshedian | Internal Medicine | 4901 W Mcdowell Rd., Phoenix, AZ 85035 | 2005-05-27 |
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Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
1346755295 | Circle The City | Clinic/Center | 210 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
1437607389 | Neighborhood Outreach Access To Health | Clinic/Center | 20440 N 27th Ave Ste 450, Phoenix, AZ 85027-3240 | 2016-09-20 |
1972907129 | Neighborhood Outreach Access To Health | Clinic/Center | 16251 N Cave Creek Rd, Phoenix, AZ 85032-2976 | 2014-10-17 |
1982830410 | Native Health | Clinic/Center | 2423 W Dunlap Ave Ste 140, Phoenix, AZ 85021-5818 | 2009-06-10 |
1386741668 | Mountain Park Health Center | Clinic/Center | 3830 E Van Buren St, Phoenix, AZ 85008-6936 | 2006-09-20 |
1770196016 | La Clinica Del Valle Family Healthcare Center Inc. | Clinic/Center | 106 N. Rose Street, Phoenix, OR 97535 | 2020-08-26 |
1164055596 | Circle The City | Clinic/Center | 3522 N 3rd Ave, Phoenix, AZ 85013-3903 | 2020-02-13 |
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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.