MOUNTAIN PARK HEALTH CENTER (NPI# 1811490881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811490881 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN PARK HEALTH CENTER |
| Practice Address |
303 E Baseline Rd Phoenix AZ 85042-6530 |
| Mailing Address |
3003 N Central Ave Ste 1600 Phoenix AZ 85012-2908 |
| Practice Telephone | 6022437277 |
| Practice Fax Number | 6022764427 |
| Mailing Telephone | 6023233344 |
| Mailing Fax Number | 3023233496 |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |
| Authorized Official Name | JOHN SWAGERT (CEO) |
| Authorized Official Telephone | 6023233470 |
| 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) |
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 |
| 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 |
| 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 |
303 E BASELINE RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85042-6530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962474668 | Mary Elizabeth Vaughan | Nurse Practitioner | 303 E Baseline Rd, Suite 203, Phoenix, AZ 85042-6530 | 2006-02-06 |
| 1801362892 | Sarah Joyce Tucker | Nurse Practitioner | 303 E Baseline Rd, Phoenix, AZ 85042-6530 | 2018-10-17 |
| 1457720765 | Rachel Kennamer | Nurse Practitioner | 303 E Baseline Rd, Phoenix, AZ 85042-6530 | 2015-09-16 |
| 1558773028 | Bobby Jean Mickens | Nurse Practitioner | 303 E Baseline Rd, Phoenix, AZ 85042-6530 | 2014-06-02 |
| 1124441944 | Spooner Physical Therapy & Hand Rehab, PC | Physical Therapist | 303 E Baseline Rd, Ste 101, Phoenix, AZ 85042-6530 | 2014-01-30 |
| 1144642653 | Trent Brooke | Physical Therapist | 303 E Baseline Rd, Ste 110, Phoenix, AZ 85042-6530 | 2014-01-17 |
| 1144658154 | Matthew Getz | Physical Therapist | 303 E Baseline Rd, Suite 110, Phoenix, AZ 85042-6530 | 2013-10-30 |
| 1831434620 | Amy Mainelli | Physical Therapist | 303 E Baseline Rd, Suite 110, Phoenix, AZ 85042-6530 | 2012-12-05 |
| 1477807485 | Spooner Phoenix Physical Therapy, Inc. | Physical Therapist | 303 E Baseline Rd, Suite 110, Phoenix, AZ 85042-6530 | 2012-10-30 |
| 1487901963 | Vilawoe Aku Boadu | Pharmacist | 303 E Baseline Rd, Suite #100, Phoenix, AZ 85085 | 2012-08-14 |
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|---|---|---|---|---|
| 1306443197 | Da Homes LLC | Case Management | 8026 S. 24th Way, Phoenix, AZ 85042 | 2020-10-05 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1427538362 | Abigail Mcgrath | Dietitian, Registered | 303 E Baseline Rd Ste 200, Phoenix, AZ 85042 | 2018-08-20 |
| 1174028310 | Olufemi A Omodara | Pharmacist | 7227 S. Central Ave, #1080, Phoenix, AZ 85042 | 2018-03-29 |
| 1720537699 | Mary Youngblood | Registered Nurse | 7210 S 27th Way, Phoenix, AZ 85042 | 2016-10-03 |
| 1922490382 | Brian Zembower | Optometrist | 610 E Baseline Rd Ste C3, Phoenix, AZ 85042 | 2015-02-23 |
| 1417299819 | Robert Murphy Portley | Psychiatry & Neurology | 2320 E Baseline Rd Ste 148-225, Phoenix, AZ 85042 | 2013-03-23 |
| 1972807998 | Obinna Chukwuka Akubukwe | Pharmacist | 6006 S. Central Avenue, Phoenix, AZ 85042 | 2011-01-05 |
| 1104120328 | Gisheys Patient Care LLC | Custodial Care Facility | 7232 South 12th Place, Phoeniz, AZ 85042 | 2011-01-03 |
| 1245463488 | Lois Ann Hammitt | Registered Nurse | 6218 S. 7th Street, Phoenix, AZ 85042 | 2009-09-03 |
| Find all providers in zip 85042 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 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 |
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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.