| Anthem Physical Medicine Llc | |
|
3624 W Anthem Way C110 Anthem AZ 85086-0440 | |
| (623) 551-9950 | |
| (623) 551-9950 |
| Full Name | Anthem Physical Medicine Llc |
|---|---|
| Speciality | General Practice |
| Location | 3624 W Anthem Way, Anthem, Arizona |
| Authorized Official Name and Position | Justin Thompson (OWNER) |
| Authorized Official Contact | 4357605896 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthem Physical Medicine Llc 3624 West Anthem Way C110 Anthem AZ 85086 Ph: (623) 551-9950 | Anthem Physical Medicine Llc 3624 W Anthem Way C110 Anthem AZ 85086-0440 Ph: (623) 551-9950 |
| NPI Number | 1700251071 |
|---|---|
| Provider Enumeration Date | 12/11/2015 |
| Last Update Date | 10/08/2020 |
| Medicare PECOS PAC ID | 4587968391 |
|---|---|
| Medicare Enrollment ID | O20160215001096 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700251071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Patrick J Domanico |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710966767 PECOS PAC ID: 3577581768 Enrollment ID: I20051107000130 |
| Provider Name | Jason R Jensen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871715367 PECOS PAC ID: 5799839205 Enrollment ID: I20100925000373 |
| Provider Name | Todd Dreitzler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063641686 PECOS PAC ID: 4981654944 Enrollment ID: I20131127000457 |
| Provider Name | Justin Thompson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1851797179 PECOS PAC ID: 6901120138 Enrollment ID: I20151029002919 |
| Provider Name | Megan M Trosko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033576038 PECOS PAC ID: 5092010389 Enrollment ID: I20160224001964 |
| Provider Name | Jess Henry Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760840581 PECOS PAC ID: 6406152933 Enrollment ID: I20160309002872 |
| Provider Name | Subash Mathew |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902037237 PECOS PAC ID: 9931255734 Enrollment ID: I20161117000068 |
| Provider Name | Julie A Osgood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801319421 PECOS PAC ID: 2264707397 Enrollment ID: I20170929000081 |
| Provider Name | Tanner Clark |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215465042 PECOS PAC ID: 5395013932 Enrollment ID: I20180205002575 |
| Provider Name | Mark Frogley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1316291966 PECOS PAC ID: 8426293432 Enrollment ID: I20180712001008 |
| Provider Name | Bryan Sims |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1962896571 PECOS PAC ID: 7012264450 Enrollment ID: I20180717002265 |
| Provider Name | Selaiman A Noori |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104244631 PECOS PAC ID: 6406114412 Enrollment ID: I20200220000938 |
| Provider Name | Sarah Jean Garrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902435795 PECOS PAC ID: 5991121568 Enrollment ID: I20200812003611 |
| Provider Name | Stephanie Megan Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568080570 PECOS PAC ID: 7315364270 Enrollment ID: I20200824003599 |
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Ternion Physician Group, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 42104 N Venture Dr, Suite D118, Anthem, AZ 85086 Phone: 623-505-9880 Fax: 623-505-9880 | |
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Gavilan Peak Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3648 W Anthem Way, A100, Anthem, AZ 85086 Phone: 623-434-6444 Fax: 623-434-6448 | |
District Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3624 W Anthem Way Ste C116, Anthem, AZ 85086 Phone: 623-434-5748 Fax: 623-551-8882 | |
Stetson Hills Family Medicine-anthem Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 41125 N Daisy Mountain Dr, Ste. 109, Anthem, AZ 85086 Phone: 623-594-6866 Fax: 623-249-4982 |