Athena Medical Group | |
16515 S 40th St Ste 143 Phoenix AZ 85048-0560 | |
(480) 712-8319 | |
(480) 712-1305 |
Full Name | Athena Medical Group |
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Speciality | Family Medicine |
Location | 16515 S 40th St Ste 143, Phoenix, Arizona |
Authorized Official Name and Position | Yancey Scott Gaither (MANAGING PARTNER) |
Authorized Official Contact | 4807128319 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Athena Medical Group 16515 S 40th St Ste 143 Phoenix AZ 85048-0560 Ph: (480) 712-8319 | Athena Medical Group 16515 S 40th St Ste 143 Phoenix AZ 85048-0560 Ph: (480) 712-8319 |
NPI Number | 1164918124 |
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Provider Enumeration Date | 07/02/2018 |
Last Update Date | 08/20/2024 |
Medicare PECOS PAC ID | 8921358706 |
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Medicare Enrollment ID | O20180829003049 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164918124 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
Provider Name | Nana Nketiah Dwomoh |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1568428431 PECOS PAC ID: 0648297028 Enrollment ID: I20051025000635 |
Provider Name | Bertha Dolly Sugerman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952474033 PECOS PAC ID: 5597836569 Enrollment ID: I20081105000882 |
Provider Name | Nancy E Kowalski |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821249780 PECOS PAC ID: 8729148002 Enrollment ID: I20081117000186 |
Provider Name | Heather A Mullenberg |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801145313 PECOS PAC ID: 8224289376 Enrollment ID: I20121119000348 |
Provider Name | Charlene F Baldwin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033546411 PECOS PAC ID: 2961628292 Enrollment ID: I20140730002884 |
Provider Name | Renee Yvonne Kellems |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659746071 PECOS PAC ID: 6002118866 Enrollment ID: I20160111001826 |
Provider Name | Diana Mccully |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972973022 PECOS PAC ID: 5991002834 Enrollment ID: I20160321002023 |
Provider Name | Vicky L Davis |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134171572 PECOS PAC ID: 1052361136 Enrollment ID: I20160909002012 |
Provider Name | Marianne Nga Parham |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679876031 PECOS PAC ID: 2062708357 Enrollment ID: I20160913001959 |
Provider Name | Teresa Marie Gaither |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568835890 PECOS PAC ID: 9931480985 Enrollment ID: I20170105000804 |
Provider Name | Sanna Neff |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083150205 PECOS PAC ID: 4789969858 Enrollment ID: I20170403000763 |
Provider Name | Tyler Ann Brockhoff |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003347147 PECOS PAC ID: 6406132778 Enrollment ID: I20170421000681 |
Provider Name | Jonathan Glenn Harris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407381189 PECOS PAC ID: 8527330596 Enrollment ID: I20170825001772 |
Provider Name | Tara M Thompson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235652942 PECOS PAC ID: 6305104563 Enrollment ID: I20171215000744 |
Provider Name | Chelsea Barson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407220676 PECOS PAC ID: 9931400520 Enrollment ID: I20171219000632 |
Provider Name | Ronald Rodriguez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114426012 PECOS PAC ID: 9335400738 Enrollment ID: I20180227003134 |
Provider Name | Andrea Kessler |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144783952 PECOS PAC ID: 7012240310 Enrollment ID: I20190530003035 |
Provider Name | Javier Gomez |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1720196801 PECOS PAC ID: 7012242555 Enrollment ID: I20190705000581 |
Provider Name | Sara Dyane Ingram |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225597727 PECOS PAC ID: 2567798218 Enrollment ID: I20190801002756 |
Provider Name | Ashlee Garcia |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508428004 PECOS PAC ID: 6507198355 Enrollment ID: I20191028001029 |
Provider Name | Razel Espiritu Hernandez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265096895 PECOS PAC ID: 4486086501 Enrollment ID: I20191112000142 |
Provider Name | Kelli K Ducray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306338736 PECOS PAC ID: 0143571026 Enrollment ID: I20191210002210 |
Provider Name | Brenda Lea Baker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376997130 PECOS PAC ID: 5799078408 Enrollment ID: I20200127000500 |
Provider Name | Lisa Wakefield |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043832264 PECOS PAC ID: 8224452610 Enrollment ID: I20200717001718 |
Provider Name | Jennifer Otterbein |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467425751 PECOS PAC ID: 8729042338 Enrollment ID: I20201020000267 |
Provider Name | Hannah Leslie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629595095 PECOS PAC ID: 1951676352 Enrollment ID: I20201124002106 |
Provider Name | Ilka Mayela Moreno |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396343430 PECOS PAC ID: 1951713791 Enrollment ID: I20201218001585 |
Provider Name | Cora-lee Behling |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851961312 PECOS PAC ID: 8325446099 Enrollment ID: I20211011001019 |
Provider Name | Zaida N Zuniga |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558869099 PECOS PAC ID: 3577826064 Enrollment ID: I20211013002199 |
Provider Name | Deborah A Gorombei |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194492306 PECOS PAC ID: 1557750262 Enrollment ID: I20211118002774 |
Provider Name | Danielle Nathina Sears |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174279509 PECOS PAC ID: 7618363649 Enrollment ID: I20220331000453 |
Provider Name | Jessica M Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619633211 PECOS PAC ID: 7214324276 Enrollment ID: I20220422000460 |
Provider Name | Taylor Bryce Mitchell |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881333110 PECOS PAC ID: 0648655563 Enrollment ID: I20220913003413 |
Provider Name | Megan Gerene Vettorel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215659644 PECOS PAC ID: 3476929084 Enrollment ID: I20221024001791 |
Provider Name | Shambre Chambers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992246763 PECOS PAC ID: 8527345180 Enrollment ID: I20230103001918 |
Provider Name | Joy Pollard-stoiber |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588392336 PECOS PAC ID: 1557731528 Enrollment ID: I20230109001138 |
Provider Name | Kristin S Landavazo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598420846 PECOS PAC ID: 9638535081 Enrollment ID: I20230510001183 |
Provider Name | Charlote Holcomb |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538835699 PECOS PAC ID: 5991161119 Enrollment ID: I20230515000282 |
Provider Name | Eddie Franklin Forehand |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275203325 PECOS PAC ID: 5890149074 Enrollment ID: I20230921001058 |
Provider Name | Michelle Raney |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558058644 PECOS PAC ID: 4486008588 Enrollment ID: I20230922002754 |
Provider Name | Valentina None Scalzullo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457053456 PECOS PAC ID: 9335593441 Enrollment ID: I20230922003024 |
Provider Name | Allison Putt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679356083 PECOS PAC ID: 6406203645 Enrollment ID: I20231109003288 |
Richard A. Snider, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 | |
Kelly H. Roy, Md, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 | |
My Family Doctor In The Valley Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Deborah L Dykema Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 | |
Scottsdale Housecall Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 | |
Wings Of Hope Medical Services, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 205, Phoenix, AZ 85029 Phone: 602-971-0304 Fax: 602-971-0305 | |
Sheperd Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9150 W Indian School Rd Ste 111b, Phoenix, AZ 85037 Phone: 623-247-2300 Fax: 623-247-1939 |