SYCAMORE AVENUE MEDICAL CENTER, PLLC (NPI# 1245762491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245762491 |
| Entity Type | Organization |
| Organization Name | SYCAMORE AVENUE MEDICAL CENTER, PLLC |
| Practice Address |
975 Sycamore Ave Kingman AZ 86409-3548 |
| Practice Telephone | 9286921900 |
| Practice Fax Number | 9286811922 |
| Mailing Telephone | 9286921900 |
| Mailing Fax Number | 9286811922 |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-04-25 |
| Authorized Official Name | SHIRLEY ANN HASKETT (CHIEF OPERATIONS OFFICER) |
| Authorized Official Telephone | 9286921900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP3349 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
975 SYCAMORE AVE |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86409-3548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295755759 | Ilangovan Govindarajan | Specialist | 975 Sycamore Ave, Kingman, AZ 86409-3548 | 2006-07-20 |
| 1326513136 | Sara Christina Rubio | Registered Nurse | 975 Sycamore Ave, Kingman, AZ 86409-3548 | 2018-10-08 |
| 1700909330 | Mohave Primary Care | Specialist | 975 Sycamore Ave, Kingman, AZ 86409-3548 | 2007-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437695731 | Medical Laboratory Specialty, Inc | Clinical Medical Laboratory | 3636 St, Kingman, AZ 86409 | 2017-01-10 |
| 1003219007 | Premier Home Health Agency | Home Health | 3555 Western Ave, Kingman, AZ 86409 | 2014-10-03 |
| 1558774984 | Fernando Velez | Pharmacist | 2003 Roy Rogers Way, Kingman, AZ 86409 | 2014-06-03 |
| 1013227834 | Route 66 Cab Inc | Taxi | 3595 E Us Highway 66, Kingman, AZ 86409 | 2010-10-14 |
| 1740503374 | Route 66 Cab Inc. | Taxi | 3595 East Hwy 66, Kingman, AZ 86409 | 2010-03-10 |
| 1649409145 | Arizona Cvs Stores, L.L.C. | Durable Medical Equipment & Medical Supplies | 3501 Stockton Hill Rd, Kingman, AZ 86409 | 2009-07-07 |
| 1790922896 | Jack Cheng-tsung Hou | Urology | 1739 E Beverly Ave Ste 106, Kingman, AZ 86409 | 2009-01-12 |
| 1710184726 | Michele F Epstein | Internal Medicine | 3571 N Moore Street, Kingman, AZ 86409 | 2007-07-02 |
| 1013118306 | Conchita O Mercado | Dentist | 1101 Riata Valley Rd, Kingman, AZ 86409 | 2007-05-31 |
| 1366585945 | Deering Therapy Services Ltd | Occupational Therapist | 1841 Morrow Ave, Kingman, AZ 86409 | 2007-02-14 |
| Find all providers in zip 86409 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902406499 | Kimberly Brown | Nurse Practitioner | 4315 N Adams St, Kingman, AZ 86409-2610 | 2020-10-26 |
| 1912548132 | Melissa Lee Cropley | Nurse Practitioner | 1380 Ellerman Dr, Kingman, AZ 86401-5489 | 2019-09-30 |
| 1588130835 | Karrie Ann Cook | Nurse Practitioner | 2331 Hualapai Mountain Rd Ste C, Kingman, AZ 86401-6207 | 2018-10-14 |
| 1740755388 | Kristin K Whitehead | Nurse Practitioner | 2043 Hope Ave, Kingman, AZ 86401-4124 | 2018-10-10 |
| 1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
| 1003895160 | Jacey Laine Mitchell | Nurse Practitioner | 1608 Stockton Hill Road #101, Kingman, AZ 86401-4142 | 2006-01-16 |
| 1891772083 | Cheryl Lynn Webb | Nurse Practitioner | 1871 Gates Ave, Kingman, AZ 86401-4017 | 2005-12-28 |
| 1275527764 | Kathleen Suzanne Florea | Nurse Practitioner | 1510 Stockton Hill Rd, Kingman, AZ 86401-5173 | 2005-09-12 |
| 1346854676 | Musick's Medical, Pllc | Nurse Practitioner | 1111 Riata Valley Rd, Kingman, AZ 86409-3678 | 2020-09-03 |
| 1033729454 | Michelle Fletcher | Nurse Practitioner | 3636 N Stockton Hill Rd, Kingman, AZ 86409-0514 | 2020-08-01 |
| Find all providers in KINGMAN | ||||
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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.