SCOTTSDALE MEDICAL CLINIC LLC - NPI 1114497864 - General Practice in Scottsdale, AZ

Q: What is the provider's specialty?

The provider's specialty is General Practice with taxonomy code 208D00000X.

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About Scottsdale Medical Clinic Llc NPPES

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

SCOTTSDALE MEDICAL CLINIC LLC (NPI 1114497864) is a healthcare organization registered as a general practice in Scottsdale, Arizona and active in the NPI registry since November 2018. The organization holds a CLIA Waiver certificate valid through May 10, 2027 and lists Michael Cormier, President, as its authorized official.

NPPES Registry Identity

NPI1114497864

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameSCOTTSDALE MEDICAL CLINIC LLC

Location Address4432 N MILLER RD STE 102Scottsdale, AZ 85251-3697

Mailing Address4432 N Miller Rd Ste 102Scottsdale, AZ 85251-3697 · (480) 306-7227

Phone(480) 306-7227

Organization SubpartNo

Authorized OfficialMichael CormierPresident · (480) 306-7227

Enumeration DateNovember 26, 2018

✔ NPI 1114497864 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

4432 N MILLER RD STE 102, Scottsdale, AZ 85251

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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

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 03D2281794

Scottsdale Medical Partners · Scottsdale, AZ

Active · expires May 10, 2027

CLIA Number03D2281794

Laboratory TypeGroup Practice

Certificate Effective DateMay 11, 2025

Certificate Expiration DateMay 10, 2027

Laboratory DirectorMichael D. Cormier

Laboratory Phone(480) 306-7227

Laboratory LocationScottsdale Medical Partners4432 N Miller Rd Ste 102, Scottsdale, AZ 85251

CLIA data matches this NPI record on: Address Phone

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

Other Providers at the Same Location NPPES 8

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

SCOTTSDALE MEDICAL PLLC

General Practice