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KACHINA FAMILY MEDICINE
NPI 1467508432
Family Medicine in Phoenix, AZ

Active since January 25, 2007CLIA 03D0917901 · Microscopy
16611 S 40TH ST, SUITE 120, PHOENIX, AZ 85048(480) 706-4100(480) 706-2600 Get Directions Write a Review

NPPES record last updated: April 30, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 31, 2020, Jan 23, 2020 (2 updates tracked since 2020).

About Kachina Family Medicine NPPES

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

KACHINA FAMILY MEDICINE (NPI 1467508432) is a healthcare organization registered as a family medicine in Phoenix, Arizona and active in the NPI registry since January 2007. The organization holds a CLIA Microscopy certificate valid through November 30, 2027 and lists Jaron Joseph Fischbeck, President, as its authorized official.

NPPES Registry Identity

NPI1467508432
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameKACHINA FAMILY PRACTICE PA
Location Address16611 S 40TH ST, SUITE 120Phoenix, AZ 85048
Mailing Address16611 S 40th St, Suite 120Phoenix, AZ 85048 · (480) 706-4100 · Fax (480) 706-2600
Phone(480) 706-4100
Fax(480) 706-2600
Organization SubpartNo
Authorized OfficialJaron Joseph FischbeckPresident · (480) 706-4100
Enumeration DateJanuary 25, 2007
Last NPPES UpdateApril 30, 20202 updates tracked since enumeration
NPPES CertifiedApril 30, 2020
✔ NPI 1467508432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
16611 S 40TH ST, Phoenix, AZ 85048
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Other Names 1

Doing Business AsKachina Family Medicine

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 for Provider-Performed Microscopy Procedures (PPMP) 03D0917901

Kachina Family Practice PA · Phoenix, AZ
Active · expires Nov 30, 2027
CLIA Number03D0917901
Laboratory TypePhysician Office
Certificate Effective DateDecember 1, 2025
Certificate Expiration DateNovember 30, 2027
Laboratory DirectorJaron J. Fischbeck
Laboratory Phone(480) 706-4100
Laboratory LocationKachina Family Practice PA16611 S 40th St Ste 120, Phoenix, AZ 85048
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

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

TARA N. BECHER PA-C
Physician Assistant
16611 S 40TH ST, SUITE 100
PHOENIX, AZ 85048
Maricopa County (480) 610-6366
TREVOR CARR PT
Physical Therapist
16611 S 40TH ST, SUITE 130
PHOENIX, AZ 85048
Maricopa County (480) 706-1199
TLC PEDIATRICS PLLC
Specialist
16611 S 40TH ST, SUITE# 160
PHOENIX, AZ 85048
Maricopa County (480) 940-8527
SPOONER PHYSICAL THERAPY & HAND REHAB, PC
Clinic/Center (Physical Therapy)
16611 S 40TH ST, SUITE 130
PHOENIX, AZ 85048
Maricopa County (480) 706-1199
MRS. DIANE K MATSUMOTO MD
Pediatrics
16611 S 40TH ST, STE 160
PHOENIX, AZ 85048
Maricopa County (480) 940-8527
RICHARD W WILSON MD
Obstetrics & Gynecology
16611 S 40TH ST, SUITE 180
PHOENIX, AZ 85048
Maricopa County (480) 785-2100
HOLLY L CAMPBELL FNP-BC
Nurse Practitioner (Family)
16611 S 40TH ST, SUITE 180
PHOENIX, AZ 85048
Maricopa County (480) 785-2100
KAREN SUE PETTIT CRNFA
Registered Nurse (Registered Nurse First Assistant)
16611 S 40TH ST, SUITE 180
PHOENIX, AZ 85048
Maricopa County (480) 785-2100

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 Kachina Family Practice PA's NPI number?

The NPI number for Kachina Family Practice PA is 1467508432. It was assigned to this organization in the NPPES registry on January 25, 2007. The provider is doing business as Kachina Family Medicine.

Where is Kachina Family Practice PA located?

Kachina Family Practice PA is located at 16611 S 40th St Suite 120, Phoenix, AZ 85048. The listed phone number is (480) 706-4100.

What is Kachina Family Practice PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Kachina Family Practice PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 03D0917901) is associated with this NPI, valid through November 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kachina Family Practice PA was last updated on April 30, 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.