PHYSICIAN PAY GROUP LLC NPI 1194609420

NPI Information

  • NPI: 1194609420
  • Provider Name: PHYSICIAN PAY GROUP LLC
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • :
  • Address: 9002 N CENTRAL AVE
    PHOENIX, AZ
    ZIP 85020
  • Phone: (480) 321-6627

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NPI Details

PHYSICIAN PAY GROUP LLC is a clinic center in Phoenix, AZ. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PHYSICIAN PAY GROUP LLC NPI is 1194609420. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

9002 N CENTRAL AVE
PHOENIX, AZ
ZIP 85020-405
Phone: (480) 321-6627

The provider's authorized official is Ali-andra Ottun .
The authorized official title is Ceo and has the following contact phone number (480) 321-6627.

The enumeration date for this NPI number is 7/31/2025 and was last updated on 8/1/2025.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2101YM0800XCounselorMental HealthNo
3101YP2500XCounselorProfessionalNo
41041C0700XSocial WorkerClinicalNo
5163WA0400XRegistered NurseAddiction (Substance Use Disorder)No
6163WC0400XRegistered NurseCase ManagementNo
7163WP0807XRegistered NursePsychiatric/Mental Health, Child & AdolescentNo
8163WP0809XRegistered NursePsychiatric/Mental Health, AdultNo
9207PE0004XEmergency MedicineEmergency Medical ServicesNo
10343900000XNon-emergency Medical Transport (VAN)No
11364SP0810XClinical Nurse SpecialistPsychiatric/Mental Health, Child & FamilyNo
12405300000XPrevention ProfessionalNo
13261Q00000XClinic/CenterYes

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: 11/21/2025

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