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MESA PHYSICIAN GROUP
NPI 1104447788
General Practice in Mesa, AZ

Active since May 05, 2020
5151 E BROADWAY RD STE 105, MESA, AZ 85206(480) 809-6587 Get Directions Write a Review

NPPES record last updated: May 6, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mesa Physician Group NPPES

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

MESA PHYSICIAN GROUP (NPI 1104447788) is a healthcare organization registered as a general practice in Mesa, Arizona and active in the NPI registry since May 2020. The organization lists Jeremiah Faber, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104447788
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameMESA PHYSICIAN GROUP
Location Address5151 E BROADWAY RD STE 105Mesa, AZ 85206-1346
Mailing AddressPo Box 964Gilbert, AZ 85299-0964 · (480) 366-4489
Phone(480) 809-6587
Organization SubpartNo
Authorized OfficialJeremiah FaberCeo · (480) 258-3635
Enumeration DateMay 5, 2020
Last NPPES UpdateMay 6, 2020
NPPES CertifiedMay 6, 2020
✔ NPI 1104447788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
5151 E BROADWAY RD STE 105, Mesa, AZ 85206
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

FREEDOM MEDICAL CARE
Family Medicine (Addiction Medicine)
5151 E BROADWAY RD STE 105
MESA, AZ 85206
Maricopa County (480) 550-6508
LINDLEY JONES NP
Nurse Practitioner (Family)
5151 E BROADWAY RD STE 105
MESA, AZ 85206
Maricopa County (480) 690-8815
JAYME LYN SHERMAN MD
Family Medicine
5151 E BROADWAY RD STE 105
MESA, AZ 85206
Maricopa County (480) 660-6451
STAT CARE MEDICAL SERVICES
Nurse Practitioner (Primary Care)
5151 E BROADWAY RD STE 105
MESA, AZ 85206
Maricopa County (480) 690-8815

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mesa Physician Group's NPI number?

The NPI number for Mesa Physician Group is 1104447788. It was assigned to this organization in the NPPES registry on May 5, 2020.

Where is Mesa Physician Group located?

Mesa Physician Group is located at 5151 E Broadway Rd Ste 105, Mesa, AZ 85206. The listed phone number is (480) 809-6587.

What is Mesa Physician Group's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Mesa Physician Group was last updated on May 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.