PINEAPPLE HEALTH - NPI 1063640977 - Family Medicine in Phoenix, AZ

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

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About Pineapple Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINEAPPLE HEALTH (NPI 1063640977) is a healthcare organization registered as a family medicine in Phoenix, Arizona and active in the NPI registry since June 2009. The organization holds a CLIA Waiver certificate valid through May 10, 2027, maintains a secondary practice location in Prescott Valley, and lists Kevin Yin Shun Chan, Owner, as its authorized official.

NPPES Registry Identity

NPI1063640977

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameDR KEVIN CHAN PC

Location Address12010 S WARNER ELLIOT LOOP STE 1Phoenix, AZ 85044-2731

Mailing Address12010 S Warner Elliot Loop Ste 1Phoenix, AZ 85044-2731 · (480) 961-2366 · Fax (480) 961-2367

Phone(480) 961-2366

Fax(480) 961-2367

Organization SubpartNo

Authorized OfficialKevin Yin Shun ChanOwner · (480) 577-8199

Enumeration DateJune 30, 2009

Last NPPES UpdateJuly 7, 2022

NPPES CertifiedJuly 7, 2022

✔ NPI 1063640977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

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.

12010 S WARNER ELLIOT LOOP STE 1, Phoenix, AZ 85044

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Other Names 2

Doing Business AsPineapple Health

Doing Business AsPineapple Health Pv

Secondary Practice Location 1

Location 13196 N Windsong DrPrescott Valley, AZ 86314-2239 · Phone (928) 772-1505 · Fax (928) 772-6343

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc..Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D0894608

Pineapple Health · Phoenix, AZ

Active · expires May 10, 2027

CLIA Number03D0894608

Laboratory TypePhysician Office

Certificate Effective DateMay 11, 2025

Certificate Expiration DateMay 10, 2027

Laboratory DirectorKevin Chan

Laboratory Phone(480) 961-2366

Laboratory LocationPineapple Health12010 S Warner-Elliot Loop, Ste 1, Phoenix, AZ 85044

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KERRY L OLIVER FNP-C

Nurse Practitioner (Primary Care)