KINGMAN HEALTHCARE, INC (NPI# 1184802480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184802480 |
| Entity Type | Organization |
| Organization Name | KINGMAN HEALTHCARE, INC |
| Other Organization Name | KINGMAN HOSPITAL, INC |
| Practice Address |
3801 Santa Rosa Dr Kingman AZ 86401-2311 |
| Mailing Address |
3269 Stockton Hill Rd Kingman AZ 86409-3619 |
| Practice Telephone | 9282635688 |
| Practice Fax Number | 9282635686 |
| Mailing Telephone | 9287570626 |
| Mailing Fax Number | 9286922706 |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2020-07-02 |
| Authorized Official Name | MR. TIM BLANCHARD (CFO) |
| Authorized Official Telephone | 9286818668 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282N00000X | General Acute Care Hospital | SH5739 | AZ | Hospitals |
| Y | 273Y00000X | Rehabilitation Unit | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | BCBS | P0913870 | 01 |
| Other Name | Type Code |
|---|---|
| Kingman Hospital, Inc | Former Legal Business Name - Organization |
| Kingman Regional Medical Center - Hualapai Mountain Campus | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3269 N Stockton Hill Rd, Kingman, AZ 864093619 | 9287570626 | 9286922706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760703805 | Kingman Healthcare, Inc | Clinic/Center | 1726 E Beverly Ave Ste A, Kingman, AZ 86409-3500 | 2010-06-11 |
| 1174701478 | Kingman Healthcare, Inc | Home Health | 2202 N Stockton Hill Rd Ste 200, Kingman, AZ 86401-4622 | 2008-02-08 |
| 1992286298 | Kingman Healthcare, Inc | Pharmacy | 1739 E Beverly Ave Ste 106, Kingman, AZ 86409-3593 | 2018-08-24 |
| 1538347836 | Kingman Healthcare, Inc | Hospice Care, Community Based | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2008-02-08 |
| 1689897787 | Kingman Healthcare, Inc | Family Medicine | 1739 Beverly Avenue, Suite 200, Kingman, AZ 86409-3593 | 2007-04-10 |
| 1265423917 | Kingman Healthcare, Inc | Home Health | 3269 N Stockton Hill Rd, Kingman, AZ 86409-3619 | 2005-11-02 |
| Street Address |
3801 SANTA ROSA DR |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401-2311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154303493 | Ben Tacheron | Anesthesiology | 3801 Santa Rosa Dr, Kingman, AZ 86401 | 2005-11-14 |
| 1801428172 | Anthony Edmond Rowden | Nurse Practitioner | 3801 Santa Rosa Dr, Kingman, AZ 86401-2311 | 2020-02-05 |
| 1275187916 | Sanana Phillips | Nurse Practitioner | 3801 Santa Rosa Dr, Kingman, AZ 86401-2311 | 2019-07-31 |
| 1689172629 | Victoria Rossi | Physician Assistant | 3801 Santa Rosa Dr, Kingman, AZ 86401 | 2018-01-24 |
| 1427342724 | Hualapai Mountain Anesthesia Pllc | Anesthesiology | 3801 Santa Rosa Dr, Kingman, AZ 86401-2311 | 2011-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
| 1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
| 1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
| 1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
| 1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
| 1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
| 1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
| 1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
| 1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
| 1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
| Find all providers in zip 86401 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518376128 | Naana Braly Therapeutic Massage &bodywork | Rehabilitation Unit | 8520 East Shea Blvd Suite 100, Scottsdale, AZ 85260 | 2014-08-07 |
| 1821259185 | Banner Del E Webb Medical Center | Rehabilitation Unit | 14501 W Meeker Blvd, Sun City West, AZ 85375 | 2008-06-19 |
| 1467506857 | Banner -- University Medical Center Phoenix | Rehabilitation Unit | 1012 E Willetta St Fl 3, Phoenix, AZ 85006-2749 | 2007-01-22 |
| 1083668578 | Sun Health Corporation | Rehabilitation Unit | 10601 W Santa Fe Dr, Sun City, AZ 85351-3036 | 2006-05-20 |
| 1235582594 | Dominic Trapp | Rehabilitation Unit | 1000 Fianna Way, Fort Smith, AZ 72919 | 2016-07-21 |
| 1538528955 | Northern Arizona Healthcare | Rehabilitation Unit | 6560 Sr 179, Suite 118, Sedona, AZ 86351-7985 | 2016-02-12 |
| 1710353339 | Smsj Tucson Holdings LLC | Rehabilitation Unit | 1601 W Saint Marys Rd, Tucson, AZ 85745-2623 | 2015-08-18 |
| 1306212923 | Smsj Tucson Holdings LLC | Rehabilitation Unit | 350 N Wilmot Rd, Tucson, AZ 85711-2602 | 2015-08-18 |
| 1669870937 | Vhs of Phoenix Inc | Rehabilitation Unit | 2000 W Bethany Home Rd, Phoenix, AZ 85015-2443 | 2014-12-18 |
| 1073954186 | Northwest Hospital LLC | Rehabilitation Unit | 6200 N La Cholla Blvd, Tucson, AZ 85741-3529 | 2013-07-17 |
| 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.