OrganizationActive
Adult Geriatric Care Group
NPI 1164174272 · Nephrology Physician · Peoria, AZ
Provider details
- NPI number
- 1164174272
- Entity type
- Organization
- Primary specialty
- Nephrology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Amory Godwin Grijaldo, Nurse Practitioner/Owner(602) 687-3273
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Primary Care Clinic/Center261QP2300X
Ambulatory Health Care Facilities
- Acute Care Nurse Practitioner363LA2100X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
12451 W Gentle Rain Rd
Peoria, AZ 85383-7198
Phone: (857) 400-7436
Fax: (888) 425-0427
Approximate (ZIP-level) locationGet directions
Mailing address
20403 N Lake Pleasant Rd Ste 117-488
Peoria, AZ 85382-9702
Registry dates
- Enumerated
- 2022-01-20
- Last updated
- 2023-05-30
- Certified
- 2023-05-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.