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IDENTITY HORMONES LLC
NPI 1326642372
Family Medicine - Adult Medicine in Phoenix, AZ

Active since November 30, 2020
100 E CAMELBACK RD STE 108, PHOENIX, AZ 85012(901) 757-3643 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 11, 2024, Nov 13, 2023, Mar 20, 2023 and 2 more (5 updates tracked since 2020).

About Identity Hormones Llc NPPES

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

IDENTITY HORMONES LLC (NPI 1326642372) is a healthcare organization registered as an adult medicine in Phoenix, Arizona and active in the NPI registry since November 2020. The organization lists Amanda Wilkinson, Business Operations Director, as its authorized official.

NPPES Registry Identity

NPI1326642372
Entity TypeOrganization
Primary Taxonomy207QA0505X
Legal Business NameIDENTITY HORMONES LLC
Location Address100 E CAMELBACK RD STE 108Phoenix, AZ 85012-1061
Mailing Address100 E Camelback Rd Ste 108Phoenix, AZ 85012-1061
Phone(901) 757-3643
Organization SubpartNo
Authorized OfficialAmanda WilkinsonBusiness Operations Director · (702) 818-0446
Enumeration DateNovember 30, 2020
Last NPPES UpdateNovember 11, 20245 updates tracked since enumeration
NPPES CertifiedNovember 11, 2024
✔ NPI 1326642372 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Adult MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0505X
Definition
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
100 E CAMELBACK RD STE 108, Phoenix, AZ 85012
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Other Names 1

Doing Business AsIdentity Hormones Llc

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 2

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

MR. MICHAEL DEREK JAORASDR APRN, FNP-C
Nurse Practitioner (Family)
100 E CAMELBACK RD STE 108
PHOENIX, AZ 85012
Maricopa County (602) 354-3925
ZACHARY TIMOTHY SCOTT BRAGG
Nurse Practitioner (Primary Care)
100 E CAMELBACK RD STE 108
PHOENIX, AZ 85012
Maricopa County (602) 354-3925

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 Identity Hormones LLC's NPI number?

The NPI number for Identity Hormones LLC is 1326642372. It was assigned to this organization in the NPPES registry on November 30, 2020.

Where is Identity Hormones LLC located?

Identity Hormones LLC is located at 100 E Camelback Rd Ste 108, Phoenix, AZ 85012. The listed phone number is (901) 757-3643.

What is Identity Hormones LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.

When was this NPI record last updated?

The NPPES record for Identity Hormones LLC was last updated on November 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.