BRANDI L DIDOMINICK (NPI# 1134608904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134608904 |
| Entity Type | Individual |
| Full Name | BRANDI L DIDOMINICK |
| Credential | PA |
| Practice Address |
2500 E Hunt Dr Show Low AZ 85901-7954 |
| Practice Telephone | 9285376937 |
| Mailing Telephone | 9285376937 |
| Enumeration Date | 2018-08-12 |
| Last Update Date | 2019-03-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2500 E HUNT DR |
| City | SHOW LOW |
| State | AZ |
| Zip Code | 85901-7954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245225309 | Victor R Henderson | Radiology | 2500 E Hunt Dr, Ste H, Show Low, AZ 85901 | 2005-09-14 |
| 1801432422 | Kyler Grant Merrill | Nurse Practitioner | 2500 E Hunt Dr, Show Low, AZ 85901-7954 | 2019-11-19 |
| 1053531608 | Alliance Healthcare Services Inc | Clinic/Center | 2500 E Hunt Dr, Show Low, AZ 85901 | 2007-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811468804 | Summit Healthcare Association | Pharmacy | 4951 South White Mountain Road, Bldg A., Suite 1500, Show Low, AZ 85901 | 2018-12-17 |
| 1821446386 | Ivy L Loney | Social Worker | 580 E. Old Linden Rd #6, Show Low, AZ 85901 | 2016-05-25 |
| 1750749214 | Summit Healthcare | General Acute Care Hospital | 181 East Sylvester, Show Low, AZ 85901 | 2016-01-29 |
| 1194153916 | Alpha & Omega Physical Therapy Acc | Physical Therapist | 861 E Cooley St # B, Show Low, AZ 85901 | 2013-10-15 |
| 1033454707 | North Country Healthcare, Inc. | Family Medicine | 2600 E. Show Low Lake Rd., Show Low, AZ 85901 | 2012-12-06 |
| 1073740098 | North Country Healthcare, Inc. | Clinic/Center | 2650 E. Show Low Lake Rd, Suite 1, Show Low, AZ 85901 | 2009-06-17 |
| 1215174768 | Coast To Coast Air Ambulance, LLC | Ambulance | 3151 Airport Loop Ste 2, Show Low, AZ 85901 | 2009-01-20 |
| 1487899712 | Akdhc, LLC | Internal Medicine | 2051 Evergreen Lane, Ste D, Your Family Practice Team, Show Low, AZ 85901 | 2008-12-16 |
| 1851553192 | Health Angels Companion Care, Inc. | Technician | 1001 E. Huning, Show Low, AZ 85901 | 2008-06-27 |
| 1528231586 | Peggy Johnson | Occupational Therapist | Cusd# 24 Hwy 191, Chinle, AZ 85901 | 2008-04-10 |
| Find all providers in zip 85901 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376035584 | Amber Lynne Radel | Physician Assistant | 1500 S White Mountain Rd Ste 300, Show Low, AZ 85901-7115 | 2018-06-04 |
| 1083677876 | Eric Olson | Physician Assistant | 2450 E Show Low Lake Rd Ste 1, Show Low, AZ 85901-7953 | 2006-04-11 |
| 1568089787 | Austin Johnson | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2020-07-03 |
| 1912463084 | Sophie Shizuyo Jessop | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2019-02-14 |
| 1689184616 | Chasen Kenneth Halcomb | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-10-04 |
| 1922527266 | Clint Adam Draney | Physician Assistant | 680 E Deuce of Clubs, Show Low, AZ 85901-4829 | 2017-09-19 |
| 1255859567 | Shane Mcbride Smith | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2017-09-07 |
| 1598286536 | Sonnier Faye Sibley | Physician Assistant | 320 E Deuce of Clubs, Show Low, AZ 85901 | 2017-06-29 |
| 1104378702 | Jessica Fain | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2016-10-29 |
| 1285087759 | Brett Mason | Physician Assistant | 2200 E Show Low Lake Rd, Show Low, AZ 85901-7831 | 2016-07-19 |
| Find all providers in SHOW LOW | ||||
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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.