CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC – NPI #1801421656
Clinic/Center

CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC is an AHC clinic located in PHOENIX, AZ. NPPES has assigned the NPI number 1801421656 to CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC on March 11, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Multi-Specialty

The NPI profile was last updated on Dec 01, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC below.

NPI Profile for
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC

NPI Number
1801421656
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC
Primary location
15255 N 40TH ST STE 135
PHOENIX, AZ 85032-4682
Phone: (480) 417-4215 Fax: (833) 279-7074
Mailing address
8 CADILLAC DR STE 300
BRENTWOOD, TN 37027-5337
Phone: (615) 425-0220 Fax: (833) 279-7074
Organization Subpart
No
Authorized Official
MATTHEW SMOLAREK
CFO
Phone: (412) 999-5188
Updated
Certification Date
Dec 01, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM1300X
- Clinic/Center / Multi-Specialty (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.