PAMELA J VANDERWALL (NPI# 1225075609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225075609 |
| Entity Type | Individual |
| Full Name | PAMELA J VANDERWALL |
| Other Name | PAMELA VANDERWALL-LOIS |
| Credential | MD |
| Practice Address |
1200 N Beaver St Flagstaff AZ 86001-3118 |
| Mailing Address |
Po Box 74950 Los Angeles CA 90074-9560 |
| Practice Telephone | 9287732261 |
| Practice Fax Number | 9287732263 |
| Mailing Telephone | 7706932622 |
| Mailing Fax Number | 7706936039 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2011-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
29877 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31627700 | 05 |
| Street Address |
1200 N BEAVER ST |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346241189 | Alvin B Elisco | Internal Medicine | 1200 N Beaver St, Fmc Hospitalists, Flagstaff, AZ 86001-3118 | 2005-08-02 |
| 1285240515 | Amika Noel | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-09-22 |
| 1669084190 | Margaret Grace Mcgough | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-08-17 |
| 1942818398 | Regan Rowson | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-07-21 |
| 1871118984 | Nancy Gloria Flores | Audiologist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-06-15 |
| 1679100705 | Kristy Anderson | Occupational Therapist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-26 |
| 1164058087 | Bryan J Ebeling | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-23 |
| 1447808407 | Bryce Aldworth Randall | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-09-03 |
| 1851952162 | Samuel Small | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-26 |
| 1235797283 | Rebecca R Boger | Dietitian, Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336120963 | Northern Arizona Radiation Oncology | Radiology | 1200 N. Beaver Street, Cancer Center of Northern Arizona, Flagstaff, AZ 86001 | 2005-11-10 |
| 1144222001 | Andrew David | Radiology | 1329 N Beaver St Ste 1, Flagstaff, AZ 86001-3127 | 2005-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790383701 | Alliance Oncology of Arizona, LLC | Radiology | 21300 N John Wayne Pkwy Ste 116, Maricopa, AZ 85139-8978 | 2020-10-12 |
| 1902305899 | Sonoran Skin Cancer Treatment Centers, LLC | Radiology | 1425 Greenfield Road, Mesa, AZ 85206 | 2018-02-06 |
| 1811307333 | Joshua R Niska | Radiology | Bmda @ Banner Boswell Medical Center, 10401 W. Thunderbird Blvd, Sun City, AZ 85351 | 2014-05-06 |
| 1053731356 | Andrew Orton | Radiology | 121 West Esperanza Blvd, 181, Green Valley, AZ 85614-6687 | 2014-04-24 |
| 1346668514 | Ashley Ann Albert | Radiology | 14155 N 83rd Ave Ste 127, Peoria, AZ 85381-5652 | 2014-04-03 |
| 1174953913 | Sung Ae Lee | Radiology | 820 W. Ravina Lane, Anthem, AZ 85086 | 2013-11-14 |
| 1366726788 | Vershalee Shukla | Radiology | 7469 E Monte Cristo Ave, Scottsdale, AZ 85260-1618 | 2011-10-04 |
| 1194988204 | David Thomas Vonk | Radiology | 6567 E Carondelet Dr Ste 100, Tucson, AZ 85710-6152 | 2008-07-08 |
| 1679767768 | Simul D Parikh | Radiology | Banner Boswell Medical Center, 10401 W. Thunderbird Blvd, Sun City, AZ 85351 | 2007-08-31 |
| 1457561086 | Kurt Andrew Wharton | Radiology | 7410 N Zanjero Blvd, Palo Verde Cancer Center-west Valley, Glendale, AZ 85308 | 2007-05-23 |
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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.