MOUNTAIN PARK HEALTH CENTER (NPI# 1740663210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740663210 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Practice Address |
4315 N Maryvale Pkwy Phoenix AZ 85031-1942 |
| Mailing Address |
3003 N Central Ave Ste 1600 Phoenix AZ 85012-2908 |
| Practice Telephone | 6022437277 |
| Mailing Telephone | 6023233345 |
| Mailing Fax Number | 6023233399 |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2018-03-13 |
| Authorized Official Name | DR. JOHN R SWAGERT (CEO) |
| Authorized Official Telephone | 6023233242 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
OTC 0599 | AZ | Ambulatory Health Care Facilities |
| 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 |
| 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 |
| 1740387018 | Mountain Park Health Center | Clinic/Center | 6601 West Thomas Road, Phoenix, AZ 85035-5700 | 2006-09-20 |
| 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 |
4315 N MARYVALE PKWY |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85031-1942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073638953 | Brett Hudson | Psychologist | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2007-03-20 |
| 1447801089 | Patricia Cordova | Dental Hygienist | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2019-09-25 |
| 1568870954 | Teresa Ault | Licensed Practical Nurse | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2014-07-29 |
| 1669672697 | Dale Ann Manzoeillo | Nurse Practitioner | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2007-07-18 |
| 1881715654 | Lindsey Binford | Speech-Language Pathologist | 4315 N Maryvale Pkwy, Phoenix, AZ 85031-1942 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508256629 | Jessica Watson | Physical Therapy Assistant | 4110 N 108th Ave, Suite 103, Phoenix, AZ 85031 | 2015-01-27 |
| 1043518707 | Lisette V Hill | Nurse Practitioner | 3802 N 53rd Avenue, Suite 160, Phoenix, AZ 85031 | 2011-03-04 |
| 1760785778 | Unlimited Smiles | Dentist | 4805 West Thomas, Suite #a, Phoenix, AZ 85031 | 2010-12-13 |
| 1043526817 | Atul J Amin | Pharmacist | 5102 W Indian School Rd (walgreens), Phoenix, AZ 85031 | 2010-08-31 |
| 1396064663 | Akdhc, LLC | Internal Medicine | 4524 N Maryvale Parkway, Akdhc, LLC - Maryvale, Ste 160, Phoenix, AZ 85031 | 2010-05-25 |
| 1629397583 | Scott Anthony Effinger | Pharmacist | 4616 N. 51st Avenue, Suite 203, Phoenix, AZ 85031 | 2010-05-18 |
| 1912237397 | Albert Potter | Counselor | 5043 W. Campbell Ave., Phoenix, AZ 85031 | 2010-01-06 |
| 1649434887 | Mahmoud Azmi Mahafzah | Internal Medicine | 5251 W Campbell Ave Ste 204, Phoenix, AZ 85031 | 2008-07-16 |
| 1427253335 | Evelyn Tan Omana-roldan | Family Medicine | 4700 N. 51st Avenue, Suite 1, Phoenix, AZ 85031 | 2007-06-19 |
| 1255416103 | Chicanos Por La Causa Inc | Clinic/Center | 4602 W. Indian School Rd., Cplc Centro De La Familia, Phoenix, AZ 85031 | 2006-10-26 |
| Find all providers in zip 85031 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1194207878 | Valle Del Sol, Inc. | Clinic/Center | 1510 S 19th Dr, Phoenix, AZ 85009-6540 | 2018-08-30 |
| 1578059168 | Native Health | Clinic/Center | 6850 W Indian School Rd Ste Nh1, Phoenix, AZ 85033-3249 | 2018-07-06 |
| 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 |
| 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.