| Optum Primary Care | |
|
2905 W Warner Rd Suite 12 Chandler AZ 85224-1674 | |
| (480) 831-8457 | |
| (480) 491-3112 |
| Full Name | Optum Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 2905 W Warner Rd, Chandler, Arizona |
| Authorized Official Name and Position | Emily Castillo (REGIONAL MANAGER) |
| Authorized Official Contact | 7024802550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum Primary Care 2905 W Warner Rd Suite 12 Chandler AZ 85224-1674 Ph: (480) 831-8457 | Optum Primary Care 2905 W Warner Rd Suite 12 Chandler AZ 85224-1674 Ph: (480) 831-8457 |
| NPI Number | 1649309816 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 09/02/2023 |
| Medicare PECOS PAC ID | 2769376342 |
|---|---|
| Medicare Enrollment ID | O20040212000948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649309816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 1601 (Arizona) | Primary |
| Provider Name | James B Vogt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740332352 PECOS PAC ID: 8921991142 Enrollment ID: I20040224000307 |
| Provider Name | Tyrone H Hanks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952587750 PECOS PAC ID: 1557415650 Enrollment ID: I20090824000295 |
| Provider Name | Jacob M Jones |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1720213598 PECOS PAC ID: 7113173709 Enrollment ID: I20120815000055 |
| Provider Name | Christopher M Serrone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366830945 PECOS PAC ID: 5597077487 Enrollment ID: I20150707001243 |
| Provider Name | Ericka A Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942771506 PECOS PAC ID: 4082951165 Enrollment ID: I20190128001949 |
| Provider Name | Stephanie Florence Whiting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871168807 PECOS PAC ID: 4587050489 Enrollment ID: I20220401000201 |
| Provider Name | Mary Ellen Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316415979 PECOS PAC ID: 6204170665 Enrollment ID: I20220706001864 |
| Provider Name | Aaron Shumway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528627627 PECOS PAC ID: 6507193505 Enrollment ID: I20221116001519 |
| Provider Name | Adia Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790004455 PECOS PAC ID: 7113237132 Enrollment ID: I20230410001092 |
| Provider Name | Kristin Jamison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245685510 PECOS PAC ID: 2567752132 Enrollment ID: I20230427002394 |
| Provider Name | Cameron James Ferrier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306531108 PECOS PAC ID: 5991167983 Enrollment ID: I20230808000850 |
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