Healthcare Provider Details

I. General information

NPI: 1669149787
Provider Name (Legal Business Name): HEALTHYU FAMILY MEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 E MCKELLIPS RD STE 107
MESA AZ
85203-9654
US

IV. Provider business mailing address

501 N 44TH ST STE 450
PHOENIX AZ
85008-6526
US

V. Phone/Fax

Practice location:
  • Phone: 602-491-0703
  • Fax: 833-429-2070
Mailing address:
  • Phone: 602-491-0701
  • Fax: 480-631-0581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHANE RYAN SPEIRS
Title or Position: CMO
Credential:
Phone: 480-495-5485