PREMISE HEALTH OF ARIZONA MEDICAL PC
NPI 1164031365
Clinic/Center - Multi-Specialty in Phoenix, AZ
NPI Status: Active since July 24, 2020
Contact Information
45 E ROANOKE AVE
STE 100
PHOENIX, AZ
ZIP 85004
Phone: (623) 552-3745
Fax: (623) 321-9606
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 03D2225564
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-20-2027
About PREMISE HEALTH OF ARIZONA MEDICAL PC
This page provides the complete NPI Profile along with additional information for Premise Health Of Arizona Medical Pc, a provider established in Phoenix, Arizona operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1164031365 assigned on July 2020. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated February 2026. The provider's
- NPI
- 1164031365
- Provider Legal Name
- PREMISE HEALTH OF ARIZONA MEDICAL PC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 45 E ROANOKE AVE STE 100 PHOENIX, AZ 85004
- Location Phone
- (623) 552-3745
- Location Fax
- (623) 321-9606
- Mailing Address
- 5500 MARYLAND WAY STE 120 BRENTWOOD, TN 37027
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-24-2020
- Last Update Date
- 02-02-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D2225564
- Facility Type
- Physician Office
- Certificate Effective Date
- May 21, 2025
- Certificate Expiration Date
- May 20, 2027
- Laboratory Director
- LINDA LANDINO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Premise Health Of Arizona Medical Pc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1164031365, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 5).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 45 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164031365, enumerated as an "organization" on July 24, 2020.
The provider is located at 45 E ROANOKE AVE STE 100 PHOENIX, AZ 85004 and the phone number is (623) 552-3745.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
