NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC (NPI# 1154689966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154689966 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC |
| Other Organization Name | VERDE VALLEY MEDICAL CLINIC: NEUROLOGY |
| Practice Address |
450 S Willard St Cottonwood AZ 86326-6743 |
| Mailing Address |
1200 North Beaver Street Attn: Managed Care Contracting Flagstaff AZ 86001-3118 |
| Practice Telephone | 9286497991 |
| Mailing Telephone | 9282136543 |
| Mailing Fax Number | 9282143613 |
| Enumeration Date | 2012-04-30 |
| 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 | 204D00000X | Neuromusculoskeletal Medicine & OMM | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Verde Valley Medical Clinic: Neurology | 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 |
| 1003230830 | Northern Arizona Healthcare Provider Group, LLC | Psychologist | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-02-14 |
| Street Address |
450 S WILLARD ST |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326-6743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073515235 | Northern Arizona Rehabilitation & Fitness | Physical Therapist | 450 S Willard St, Ste 106, Cottonwood, AZ 86326-6744 | 2005-06-01 |
| 1669867719 | Maxwell John Matson | Internal Medicine | 450 S Willard St, Cottonwood, AZ 86326 | 2015-04-04 |
| 1518373901 | April Schleier | Nurse Practitioner | 450 S Willard St, Cottonwood, AZ 86326-6743 | 2014-07-07 |
| 1730511296 | Julia M Trainor | Nurse Practitioner | 450 S Willard St, Suite 115, Cottonwood, AZ 86326-6743 | 2013-08-06 |
| 1821330028 | Celeste Cheri Scalf | Nurse Practitioner | 450 S Willard St, Suite 115, Cottonwood, AZ 86326-6743 | 2013-03-26 |
| 1417215229 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 450 S Willard St, Cottonwood, AZ 86326-6743 | 2012-04-30 |
| 1174881973 | Northern Arizona Healthcare Provider Group, LLC | Orthopaedic Surgery | 450 S Willard St, Cottonwood, AZ 86326-6743 | 2012-04-30 |
| 1790058915 | Joshua Joseph Gibbons | Internal Medicine | 450 S Willard St, Suite 107, Cottonwood, AZ 86326-6743 | 2012-02-18 |
| 1205153699 | Corey Ellis Sonnett | Physician Assistant | 450 S Willard St, Suite 105, Cottonwood, AZ 86326-6743 | 2010-04-26 |
| 1134457666 | Verde Valley Medical Center | Orthopaedic Surgery | 450 S Willard St, Cottonwood, AZ 86326 | 2009-11-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679954895 | Isabelle Maisse Griffith | Pharmacist | 1100 E Highway 89a, Cottonwood, AZ 86326 | 2015-06-12 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1922391663 | Ronald D. Carsrud | Hearing Instrument Specialist | 657 E Cottonwood St., Ste 6c, Cottonwood, AZ 86326 | 2011-05-26 |
| 1760712749 | Chuck Thomas Calvano | Pharmacist | 550 S Main, Cottonwood, AZ 86326 | 2010-01-13 |
| 1528231438 | Elizabeth Lightner Mccarrell | Emergency Medicine | 269 S Candy Lane, Cottonwood, AZ 86326 | 2008-04-11 |
| 1972783355 | The Wick Home for Emotional Growth and Recovery | Residential Treatment Facility, Emotionally Disturbed Children | 2102 E Fir St, Cottonwood, AZ 86326 | 2007-11-14 |
| 1750560165 | David T Sayle | Nurse Practitioner | 800 Cove Parkway, Cottonwood, AZ 86326 | 2007-11-01 |
| 1003001033 | Country Care Inc | Assisted Living Facility | 3980 E Cassie Lane, Cottonwood, AZ 86326 | 2007-09-12 |
| 1154527778 | Laurel A Mueller | Family Medicine | 51 Brian Mickelsen Pkwy, Community Health Center of Yavapai, Cottonwood, AZ 86326 | 2007-06-21 |
| 1841401700 | Bruce Alan Moseng | Chiropractor | 240 Jennifer Lane, Ste 103, Cottonwood, AZ 86326 | 2007-05-24 |
| Find all providers in zip 86326 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326253444 | Lisa Coffey Oliver | Neuromusculoskeletal Medicine & OMM | 989 S Main St Ste A, Cottonwood, AZ 86326-4602 | 2007-05-11 |
| 1003875790 | Craig Edward Hoffbauer | Neuromusculoskeletal Medicine & OMM | 529 W Mingus Ave, Cottonwood, AZ 86326-4073 | 2006-03-21 |
| 1609134410 | Northern Arizona Healthcare Provider Group, LLC | Neuromusculoskeletal Medicine & OMM | 269 South Candy Lane, Cottonwood, AZ 86326-4158 | 2012-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790191211 | Tucson Neuro Associates, LLC | Neuromusculoskeletal Medicine & OMM | 10645 N Oracle Rd Ste 121, Md 299, Oro Valley, AZ 85737-9388 | 2014-07-03 |
| 1912240532 | Nca Holdings of Arizona LLC | Neuromusculoskeletal Medicine & OMM | 8994 E Desert Cove Dr, Suite 200, Scottsdale, AZ 85260-7901 | 2013-04-02 |
| 1174870174 | Emily Jane Burgoon | Neuromusculoskeletal Medicine & OMM | 45 Castle Rock Rd 2a, Sedona, AZ 86351-8806 | 2012-08-08 |
| 1467721456 | David Steven Miller | Neuromusculoskeletal Medicine & OMM | 7773 W Libby St, Glendale, AZ 85308-8240 | 2011-12-20 |
| 1407087349 | Lauren Anne Pihlgren | Neuromusculoskeletal Medicine & OMM | 2030 W. Hwy 89a, Suite B-4, Sedona, AZ 86336 | 2009-07-27 |
| 1851507446 | Diane Clawson, D.o., P.C. | Neuromusculoskeletal Medicine & OMM | 19841 N 27th Ave Ste 302, Phoenix, AZ 85027-4006 | 2007-05-14 |
| 1235268186 | Clyde L. Imhoff, Jr. | Neuromusculoskeletal Medicine & OMM | 411 W 8th St, Yuma, AZ 85364-2957 | 2007-03-05 |
| 1821167313 | Roger S. Andersen | Neuromusculoskeletal Medicine & OMM | 1923 N Trekell Rd, Casa Grande, AZ 85222-1706 | 2006-11-07 |
| 1962440099 | William James Brooks | Neuromusculoskeletal Medicine & OMM | 5363 E Pima St Ste 100, Tucson, AZ 85712-3663 | 2006-06-02 |
| 1326018557 | Afeworki Ocbaghiorgis Kidane | Neuromusculoskeletal Medicine & OMM | 6641 E Baywood Ave, Mesa, AZ 85206-1723 | 2006-01-23 |
| Find all providers with the same taxonomy | ||||
| City | COTTONWOOD |
| Zip Code | 86326 |
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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.