| Its North Clinic | |
|
19401 N Cave Creek Rd 18 Its North Clinic Phoenix AZ 85024-1825 | |
| (602) 996-0099 | |
| (602) 996-1915 |
| Full Name | Its North Clinic |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 19401 N Cave Creek Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Janelle Lever (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 6029960110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Its North Clinic 19401 N Cave Creek Rd 18 Administrative Office Phoenix AZ 85024-1825 Ph: (602) 996-0105 | Its North Clinic 19401 N Cave Creek Rd 18 Its North Clinic Phoenix AZ 85024-1825 Ph: (602) 996-0099 |
| NPI Number | 1811073059 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 6800220757 |
|---|---|
| Medicare Enrollment ID | O20191231000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811073059 | NPI | - | NPPES |
| AZ10081M | Other | AZ | FDA |
| 955023 | Other | AZ | AHCCCS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | BH 2623 (Arizona) | Primary |
| Provider Name | Michael J Ahmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720245806 PECOS PAC ID: 9335217033 Enrollment ID: I20081008000386 |
| Provider Name | Perla Quinones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003269697 PECOS PAC ID: 0446538417 Enrollment ID: I20161025003047 |
| Provider Name | Cicili Arockiaraj |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730567801 PECOS PAC ID: 9537421706 Enrollment ID: I20180328000996 |
| Provider Name | Kristin Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235688227 PECOS PAC ID: 6103250071 Enrollment ID: I20191231000862 |
| Provider Name | Tirsit Gebresenbet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790204600 PECOS PAC ID: 2769816453 Enrollment ID: I20200106002483 |
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