PONDEROSA HEART HOUSE CALL (NPI# 1073131561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073131561 |
| Entity Type | Organization |
| Organization Name | PONDEROSA HEART HOUSE CALL |
| Practice Address |
115 S Alto St Ste 3 Prescott AZ 86303-3603 |
| Practice Telephone | 9285832113 |
| Mailing Telephone | 9285832113 |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2020-09-04 |
| Authorized Official Name | COLE BEWLEY (PHYSICAN ASSISTANT/ OWNER) |
| Authorized Official Telephone | 9285832113 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Street Address |
115 S ALTO ST STE 3 |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86303-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518447598 | Jacqueline Schlosser | Respite Care | 237 S. Washington Ave., Prescott, AZ 86303 | 2018-08-18 |
| 1033699210 | Anna Rachel Seno | Psychologist | 300 S Granite Street, Prescott, AZ 86303 | 2018-08-17 |
| 1871944322 | Jessie Deverna | Counselor | 450 W Goodwin St Suite 103b, Prescott, AZ 86303 | 2016-06-27 |
| 1154782845 | Walmart | Pharmacy | 1120 N. Opal Dr., Prescott, AZ 86303 | 2016-03-09 |
| 1710377650 | Compass Recovery Center LLC | Clinic/Center | 711 S. Granite St, Prescott, AZ 86303 | 2015-01-30 |
| 1154727527 | Anne Gurley Klever | Pharmacist | 500 Arizona 89, Prescott, AZ 86303 | 2014-11-13 |
| 1295131860 | Kathi Sabot | Registered Nurse | 146 S. Granite Street, Prescott Unified School District, Prescott, AZ 86303 | 2014-11-10 |
| 1457697989 | Kim K. Mcintyre | Counselor | 505 S. Cortez St., Prescott, AZ 86303 | 2013-01-03 |
| 1578885257 | Wesley Carl Kitchens | Counselor | 315 W Goodwin St, Prescott, AZ 86303 | 2010-02-22 |
| 1588805907 | Jacob Lee Bean | Physical Therapist | 6820 El Dorado Dr, Prescott, AZ 86303 | 2009-03-14 |
| Find all providers in zip 86303 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356698831 | Barbara Ann Bruno | Internal Medicine | 5330 E Softwind Trl, Prescott, AZ 86303-6884 | 2012-08-14 |
| 1194835199 | Andrew S Newton | Internal Medicine | 919 Twelfth Place, Suite 14, Prescott, AZ 86305 | 2006-08-30 |
| 1114928025 | Jerome C Robinson | Internal Medicine | 802 Ainsworth Dr Ste A, Prescott, AZ 86301-1623 | 2005-08-02 |
| 1730188095 | Stephen A Cantor | Internal Medicine | 726 Gail Gardner Way, Suite B, Prescott, AZ 86305 | 2005-07-19 |
| 1558997742 | Heart Shop, LLC | Internal Medicine | 242 Whipple St, Prescott, AZ 86301-1787 | 2020-03-19 |
| 1548701618 | Scottsdale Heart Health & Wellness Pllc | Internal Medicine | 919 12th Pl, 10, Prescott, AZ 86305-1433 | 2017-03-09 |
| 1609004233 | Yusuf Hassan | Internal Medicine | 726 Gail Gardner Way, Suite A, Prescott, AZ 86305-2314 | 2009-06-22 |
| 1255582003 | Yavapai Regional Medical Center Physician Care LLC | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2008-10-09 |
| 1063660025 | Yavapai Regional Medical Center Physician Care | Internal Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2008-09-03 |
| 1669647137 | Stephen A. Cantor, M.d., P.C. | Internal Medicine | 980 Willow Creek Rd, Suite 201, Prescott, AZ 86301-1611 | 2008-04-25 |
| Find all providers in PRESCOTT | ||||
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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.