| Team Select Mobile Physician Services | |
|
8787 N Scottsdale Rd Ste 105 Scottsdale AZ 85253-2338 | |
| (623) 624-7425 | |
| (623) 624-7158 |
| Full Name | Team Select Mobile Physician Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 8787 N Scottsdale Rd Ste 105, Scottsdale, Arizona |
| Authorized Official Name and Position | Byron Grayson (OWNER) |
| Authorized Official Contact | 6239860500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Team Select Mobile Physician Services Po Box 6135 Sun City West AZ 85376-6135 Ph: (623) 624-7425 | Team Select Mobile Physician Services 8787 N Scottsdale Rd Ste 105 Scottsdale AZ 85253-2338 Ph: (623) 624-7425 |
| NPI Number | 1073148326 |
|---|---|
| Provider Enumeration Date | 03/06/2020 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 6608298419 |
|---|---|
| Medicare Enrollment ID | O20200624002619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073148326 | NPI | - | NPPES |
| Provider Name | Catherine Lacourt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942232988 PECOS PAC ID: 8123080637 Enrollment ID: I20050923000304 |
| Provider Name | Paul J Gilbert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154343358 PECOS PAC ID: 8628087392 Enrollment ID: I20080821000596 |
| Provider Name | Jennifer K Billingsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447405196 PECOS PAC ID: 3375669773 Enrollment ID: I20100922001069 |
| Provider Name | Charles E Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972666154 PECOS PAC ID: 4688858491 Enrollment ID: I20110401000619 |
| Provider Name | Elsa Cedillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760840391 PECOS PAC ID: 7113226978 Enrollment ID: I20160428001312 |
| Provider Name | Carlos Manuel Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265738942 PECOS PAC ID: 0840585931 Enrollment ID: I20160829001949 |
| Provider Name | Erin E Phipps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659819993 PECOS PAC ID: 9931486412 Enrollment ID: I20170510002255 |
| Provider Name | Nicole Barth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417497066 PECOS PAC ID: 0042576175 Enrollment ID: I20171106003166 |
| Provider Name | Myungran Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639687684 PECOS PAC ID: 8921358086 Enrollment ID: I20180911001913 |
| Provider Name | Clayton A Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053898031 PECOS PAC ID: 9537404751 Enrollment ID: I20181217001781 |
| Provider Name | Eunmee Chung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255981593 PECOS PAC ID: 0749613065 Enrollment ID: I20191127000654 |
| Provider Name | Courtney K Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669948030 PECOS PAC ID: 4880002351 Enrollment ID: I20210421002881 |
| Provider Name | Kristin V Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477155018 PECOS PAC ID: 5395147417 Enrollment ID: I20210713000849 |
| Provider Name | Erin Jean Mcmanus-tomanek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104425123 PECOS PAC ID: 5092126573 Enrollment ID: I20210927000176 |
| Provider Name | Tyler Kimsey Aman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225706286 PECOS PAC ID: 4688066376 Enrollment ID: I20220421001396 |
| Provider Name | Tesha Marie Hopphaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588385884 PECOS PAC ID: 3678945235 Enrollment ID: I20230207002865 |
| Provider Name | Micah Ruben Ruybalid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619695277 PECOS PAC ID: 7911370127 Enrollment ID: I20230308001468 |
| Provider Name | Kari Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568159226 PECOS PAC ID: 0345697330 Enrollment ID: I20231113003350 |
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