GAVILAN PEAK FAMILY PRACTICE
NPI 1336132208
Family Medicine in Anthem, AZ

NPI Status: Active since August 25, 2005

Contact Information

3648 W ANTHEM WAY
A100
ANTHEM, AZ
ZIP 85086
Phone: (623) 434-6444
Fax: (623) 434-6448

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  • Organization
  • Family Medicine
  • CLIA Number: 03D1017232
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-18-2025

About GAVILAN PEAK FAMILY PRACTICE

This page provides the complete NPI Profile along with additional information for Gavilan Peak Family Practice, a primary care provider established in Anthem, Arizona operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1336132208 assigned on August 2005. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Gavilan Peak Family Practice. The authorized official of this NPI record is Savas Petrides (Svp/ceo)

NPI
1336132208
Provider Legal Name
HONORHEALTH MEDICAL GROUP, LLC
Other Organization Name
GAVILAN PEAK FAMILY PRACTICE
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3648 W ANTHEM WAY A100 ANTHEM, AZ 85086
Location Phone
(623) 434-6444
Location Fax
(623) 434-6448
Mailing Address
2500 W UTOPIA RD STE 100 PHOENIX, AZ 85027
Mailing Phone
(480) 587-5314
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-25-2005
Last Update Date
09-17-2020
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A primary care provider (PCP) like Gavilan Peak Family Practice sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SAVAS PETRIDES

Authorized Official Title
SVP/CEO
Authorized Official Phone
(480) 696-4020

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
03D1017232
Facility Type
Physician Office
Certificate Effective Date
September 19, 2023
Certificate Expiration Date
September 18, 2025
Laboratory Director
PAUL SIECKMANN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Gavilan Peak Family Practice to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1336132208
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
236623420
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 6 + 6 + 2 + 3 + 4 + 2 + 0 + 24 = 52
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 52 = 88

The NPI number 1336132208 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 12 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1174829360NORTH MOUNTAIN IMAGING SPECIALISTS, LLC
Organization
Radiology (Diagnostic Radiology)3648 W ANTHEM WAY BUILDING A-100
ANTHEM, AZ 85086
(623) 780-3751
1063444552 EMILY WINETT M.D.
Individual
Family Medicine3648 W ANTHEM WAY BLDG A100
ANTHEM, AZ 85086
(623) 434-6444
1902933823 STEPHEN WALTER WILLIAMS D.O.
Individual
Family Medicine3648 W ANTHEM WAY BLDG A-100
ANTHEM, AZ 85086
(623) 434-6444
1063405090 MELANIE CHRISTINE PATTON MD
Individual
Family Medicine3648 W ANTHEM WAY A-100
ANTHEM, AZ 85086
(623) 434-6444
1578942165 JODI MARIE PALMER FNP
Individual
Nurse Practitioner3648 W ANTHEM WAY BLDG. A-100,
ANTHEM, AZ 85086
(623) 434-6444
1831546936HONORHEALTH
Organization
Non-Pharmacy Dispensing Site3648 W ANTHEM WAY A-100
ANTHEM, AZ 85086
(623) 434-6467
1447622782MRS. ERIN ELIZABETH SHELTON NP-C, RN
Individual
Nurse Practitioner (Family)3648 W ANTHEM WAY
ANTHEM, AZ 85086
(623) 434-6444
1487851358 JOHN PHAM D.O.
Individual
Family Medicine (Adult Medicine)3648 W ANTHEM WAY SUITE A100
ANTHEM, AZ 85086
(623) 434-6444
1073609848JOHN C LINCOLN LLC
Organization
Family Medicine3648 W ANTHEM WAY SUITE A100
ANTHEM, AZ 85086
(602) 485-7482
1518235381HONORHEALTH MEDICAL GROUP, LLC
Organization
Radiologic Technologist3648 W ANTHEM WAY A-100
ANTHEM, AZ 85086
(623) 434-4444
1538656715 HEATHER IRIS SMITH MSN, FNP-C, CLT
Individual
Nurse Practitioner3648 W ANTHEM WAY
ANTHEM, AZ 85086
(803) 247-0004
1447789359 FREYDA LETICIA VELAZQUEZ PEREZ MD
Individual
Family Medicine3648 W ANTHEM WAY
ANTHEM, AZ 85086
(623) 434-6444

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1336132208, enumerated in the NPI registry as an "organization" on August 25, 2005

The provider is located at 3648 W Anthem Way A100 Anthem, Az 85086 and the phone number is (623) 434-6444

This medical organization specializes in Family Medicine with taxonomy code 207Q00000X

The provider's CLIA number is 03D1017232 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on August 25, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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