NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC (NPI# 1003230830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003230830 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC |
| Other Organization Name | TEAM HEALTH PSYCHOLOGY |
| Practice Address |
107 E Oak Ave Flagstaff AZ 86001-1818 |
| Mailing Address |
1200 N Beaver St Attn: Managed Care Contracting Flagstaff AZ 86001-3118 |
| Practice Telephone | 9289138800 |
| Practice Fax Number | 9289138801 |
| Mailing Telephone | 9282136543 |
| Mailing Fax Number | 9282143613 |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2019-04-16 |
| Authorized Official Name | RONALD F HAASE (NAH CHIEF SYSTEMS OFFICER) |
| Authorized Official Telephone | 9287732059 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHERN ARIZONA HEALTHCARE CORP |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Team Health Psychology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417384371 | Northern Arizona Healthcare Provider Group, LLC | Optometrist | 1298 W Finnie Flat Rd # 101, Camp Verde, AZ 86322-5958 | 2013-10-08 |
| 1851659817 | Northern Arizona Healthcare Provider Group, LLC | Surgery | 199 South Candy Lane, Cottonwood, AZ 86326-4183 | 2012-04-27 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1386099869 | Northern Arizona Healthcare Provider Group, LLC | Anesthesiology | 1200 N. Beaver Street, Attn: Payer Credentialing, Flagstaff, AZ 86001-3118 | 2016-05-03 |
| 1295121903 | Northern Arizona Healthcare Provider Group, LLC | Obstetrics & Gynecology | 269 South Candy Lane, Flagstaff, AZ 86326 | 2015-04-09 |
| 1174914915 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2015-02-16 |
| 1699182188 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2014-07-16 |
| 1265846968 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2014-06-20 |
| 1740694470 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-06-20 |
| 1508299728 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2013-08-12 |
| Street Address |
107 E OAK AVE |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316931702 | Jon R Shereck | Orthopaedic Surgery | 107 E Oak Ave, Flagstaff, AZ 86001 | 2005-08-31 |
| 1013546340 | Zachary Scott Hinger | Orthopaedic Surgery | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2020-04-08 |
| 1548746928 | Sarah Wyard | Nurse Practitioner | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2018-07-18 |
| 1255799789 | Iris Maczura | Nurse Practitioner | 107 E Oak Ave, Suite 201, Flagstaff, AZ 86001-1818 | 2016-01-28 |
| 1568870988 | Megan Marie Alatorre | Physician Assistant | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-07-29 |
| 1740694470 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-06-20 |
| 1104260421 | Northern Arizona Healthcare Provider Group, LLC | Clinical Neuropsychologist | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2013-04-18 |
| 1801133566 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2013-01-14 |
| 1508119348 | Northern Arizona Healthcare Provider Group, LLC | Psychiatry & Neurology | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2012-10-17 |
| 1689923096 | Justin Michael Delange | Psychiatry & Neurology | 107 E Oak Ave, Suite 101, Flagstaff, AZ 86001-1818 | 2012-08-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346853454 | Tim Buschmann | Psychologist | 5288 S Azurite Trl, Flagstaff, AZ 86005-6812 | 2020-08-28 |
| 1720552193 | Paul Andrew Nockels | Psychologist | 3600 Fox Lair Dr, Flagstaff, AZ 86004-7796 | 2019-01-17 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| 1215175377 | Judith Ann Waugh | Psychologist | 3876 N Forest Brook St, Flagstaff, AZ 86004-6820 | 2009-01-28 |
| 1720209307 | Beverlee J Gibbs-cassady | Psychologist | 416 N Kendrick St Ste 3, Flagstaff, AZ 86001-1598 | 2007-05-01 |
| 1417170440 | James Joy Cox | Psychologist | 416 North Kendrick Street, Suite 6, Flagstaff, AZ 86001 | 2007-04-10 |
| 1932239753 | Cori Kay Perkins | Psychologist | 2655 W Hogan Dr, Flagstaff, AZ 86001-1185 | 2007-03-07 |
| 1750416418 | Valarie Louise Hannemann | Psychologist | 1851 W Getaway Trl, Flagstaff, AZ 86001-8569 | 2007-02-22 |
| 1396895363 | Susan K Patrick | Psychologist | 617 N Humphreys St Ste 101, Flagstaff, AZ 86001-3063 | 2007-01-11 |
| 1336200260 | Michael Edward Gerner | Psychologist | 3 N Leroux St, Suite 207, Flagstaff, AZ 86001-5539 | 2006-12-13 |
| Find all providers in FLAGSTAFF | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.