Provider Demographics
NPI:1043371826
Name:NEXTCARE ARIZONA LLC
Entity type:Organization
Organization Name:NEXTCARE ARIZONA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-705-8558
Mailing Address - Street 1:2145 E BASELINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1546
Mailing Address - Country:US
Mailing Address - Phone:888-705-8558
Mailing Address - Fax:480-776-0025
Practice Address - Street 1:914 N SCOTTSDALE RD STE 104
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85288-2116
Practice Address - Country:US
Practice Address - Phone:480-924-8382
Practice Address - Fax:480-924-8382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ172695Medicaid
AZZ113664Medicare PIN