PHOENIX HEALTHCARE LLC NPI 1679022651

NPI Information

  • NPI: 1679022651
  • Provider Name: PHOENIX HEALTHCARE, LLC
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • Address: 61 PROSPECT ST
    GLOUCESTER, MA
    ZIP 01930
  • Phone: (617) 669-3171

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NPI Details

PHOENIX HEALTHCARE, LLC is an addiction medicine family medicine in Gloucester, MA. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. PHOENIX HEALTHCARE, LLC NPI is 1679022651. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

61 PROSPECT ST
GLOUCESTER, MA
ZIP 01930-929
Phone: (617) 669-3171

The provider's authorized official is Yvonne Smikle .
The authorized official title is Owner/member and has the following contact phone number (617) 669-3171.

The enumeration date for this NPI number is 10/1/2016 and was last updated on 10/1/2016.

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
1207QA0401XFamily MedicineAddiction Medicine216727MASSACHUSETTSYes

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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