EMBRY RIDDLE WELLNESS CENTER (NPI# 1104166727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104166727 |
| Entity Type | Organization |
| Organization Name | EMBRY RIDDLE WELLNESS CENTER |
| Practice Address |
3700 Willow Creek Rd Prescott AZ 86301-3721 |
| Practice Telephone | 9287776653 |
| Mailing Telephone | 9287776653 |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2013-02-19 |
| Authorized Official Name | SANDRA PALMER (DIRECTOR) |
| Authorized Official Telephone | 9287776653 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | ELLEN BUNCH MD TYPE I NPI | 1730289380 | 01 |
| AZ | PETER POWERS MD TYPE I NPI | 1649376831 | 01 |
| Street Address |
3700 WILLOW CREEK RD |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-3721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740623339 | Sandra F Palmer | Registered Nurse | 3700 Willow Creek Rd, Prescott, AZ 86301-3721 | 2013-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215960117 | Gary Robert Melvin | General Practice | 1024 Sunlit Dr, Prescott, AZ 86303-5131 | 2006-07-07 |
| 1437157203 | John Joseph Oconnor | General Practice | 3109 Clearwater Drive, Ste A, Prescott, AZ 86305 | 2005-07-14 |
| 1659379915 | Antonio F Mendiola Jr. | General Practice | 1827 Greenwood Rd, Prescott, MI 48756-8626 | 2005-07-12 |
| 1750937868 | Spectrum Healthcare Group, Inc | General Practice | 990 Willow Creek Rd, Prescott, AZ 86301-1640 | 2019-08-14 |
| 1538376918 | Essential Care Family Medicine, P.C. | General Practice | 3111 Clearwater Dr, Suite C, Prescott, AZ 86305-7186 | 2007-05-16 |
| 1215044938 | Margaret Shamonsky | General Practice | 500 N. Highway 89, Prescott, AZ 86313 | 2006-08-25 |
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| 1366080475 | Madison Taylor Phillips | General Practice | 15741 Bering St, Ehrenberg, AZ 85334-0010 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
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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.