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APACHE JUNCTION PEDIATRICS NPI 1588866453


NPI Information

NPI: 1588866453
Provider Name: APACHE JUNCTION PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
1075 S IDAHO RD
SUITE 206
APACHE JUNCTION, AZ
ZIP 85219
Phone: (480) 889-1234
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APACHE JUNCTION PEDIATRICS is a pediatrics in Apache Junction, AZ. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. APACHE JUNCTION PEDIATRICS NPI is 1588866453. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1075 S IDAHO RD
SUITE 206
APACHE JUNCTION, AZ
ZIP 85219-496
Phone: (480) 889-1234

The provider's authorized official is Janet Gradle .
The authorized official title is Certified Pediatric Nurse Practione and has the following contact phone number (480) 889-1234.

The enumeration date for this NPI number is 6/4/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics34596ARIZONANo
2208000000XPediatrics27900ARIZONANo
3208000000XPediatrics34587ARIZONANo
4208000000XPediatricsAP0241ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1088674MEDICAIDARIZONA
2971409MEDICAIDARIZONA
3AZ0427690OTHERARIZONARL BC ID
4AZ0763370OTHERARIZONAJB BC ID
5907397MEDICAIDARIZONA
6F14456MEDICAIDARIZONA
7524729MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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