Memd Provider Network LLC (NPI# 1376154625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1376154625 |
| Entity Type | Organization |
| Organization Name | MEMD PROVIDER NETWORK LLC |
| Practice Address |
6910 E Chauncey Ln Ste 220 Phoenix AZ 85054-5162 |
| Practice Telephone | 4803394573 |
| Mailing Address |
6910 E Chauncey Ln Ste 220 Phoenix AZ 85054-5162 |
| Mailing Telephone | 4803394573 |
| Authorized Official Name | Glenn Dean (CFO) |
| Authorized Official Telephone | 4803394573 |
| Organization Subpart | No, this organization is not a Subpart |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2020-09-22 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| No | 261QU0200X | Clinic/Center · Urgent Care | Ambulatory Health Care Facilities |
| 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 |
|---|---|---|---|---|
| 1205432705 | Renae Tylynne Mitchell | Family Medicine | 17223 N Cave Creek Rd Unit 9, Phoenix, AZ 85032-2481 | 2020-12-09 |
| 1194339200 | Madison Le | Family Medicine | 3037 W Cat Balue Dr, Phoenix, AZ 85027-2342 | 2020-09-04 |
| 1720604069 | Good Health Medical, PC | Family Medicine | 2632 S 83rd Ave Ste 113, Phoenix, AZ 85043-7206 | 2020-06-23 |
| 1427670751 | Florence Wellness Pllc | Family Medicine | 101 E Washington St Fl 7, Phoenix, AZ 85004-2450 | 2020-05-08 |
| 1073148326 | Team Select Mobile Physicians Az LLC | Family Medicine | 2999 N 44th St Ste 110, Phoenix, AZ 85018-7247 | 2020-03-06 |
| 1437782257 | Jillian Knapp | Family Medicine | 521 W Butler Dr, Phoenix, AZ 85021-4526 | 2020-02-20 |
| 1780215681 | Sip Home Systems - Mesa LLC | Family Medicine | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1861033912 | Vanessa Lissette Lara | Family Medicine | 1459 E Flower St, Phoenix, AZ 85014-5666 | 2019-09-30 |
| 1366007411 | Marceline E Ndum | Family Medicine | 10631 S. 51st Street, Suite 1, Phoenix, AZ 85044-5225 | 2019-05-03 |
| 1245795459 | Carelock, LLC | Family Medicine | 2920 E Mohawk Ln Ste 101, Phoenix, AZ 85050-4773 | 2019-02-01 |
| Find all providers in PHOENIX | ||||
| Street Address |
6910 E CHAUNCEY LN STE 220 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85054-5162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992255301 | Stephanie Gamber | Registered Nurse | 5405 East Pinnacle Vista Drive, Phoenix, AZ 85054 | 2016-10-10 |
| 1508231960 | Deborah Elam | Acupuncturist | 5777 East Mayo Boulevard Mayo Clinic, Phoenix, AZ 85054 | 2015-12-09 |
| 1811176860 | Desert Ridge Pediatric Dentistry | Clinic/Center | 5315 E. High Street, Suite 115, Phoenix, AZ 85054 | 2007-10-26 |
| 1902968639 | Ryan David Schulze | Chiropractor | 7000 E Mayo Blvd Ste 1058, Phoenix, AZ 85054 | 2006-12-16 |
| 1477517423 | Gary Betz II Md PC | Internal Medicine | 7010 E. Chauncey Lane, Suite 145, Phoenix, AZ 85054 | 2006-04-14 |
| 1689658395 | Alice G Mccormick | Internal Medicine | 5450 East Deer Valley Drive Unit 3206, Phoenix, AZ 85054 | 2005-12-06 |
| 1770576241 | Michelle Renee Kuhn | Physician Assistant | 6950 E Chauncey Ln, Phoenix, AZ 85054 | 2005-08-30 |
| 1609869981 | Jeffrey Alan Smith | Optometrist | 18325 N Allied Way Ste 100, Phoenix, AZ 85054 | 2005-08-23 |
| 1043219389 | Hasan Khamash | Internal Medicine | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2005-07-19 |
| 1497753750 | Rajeev Agarwal | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2005-07-11 |
| Find all providers in zip 85054 | ||||
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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.