GREGORY DANIEL NOVAK (NPI# 1275511156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275511156 |
| Entity Type | Individual |
| Full Name | GREGORY DANIEL NOVAK |
| Credential | MD |
| Practice Address |
269 S Candy Ln Cottonwood AZ 86326-4158 |
| Mailing Address |
1200 N Beaver St Payer Credentialing Flagstaff AZ 86001-3118 |
| Practice Telephone | 9286396180 |
| Practice Fax Number | 9286396698 |
| Mailing Telephone | 9287732559 |
| Mailing Fax Number | 9282136292 |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2016-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
41896 | AZ | Allopathic & Osteopathic Physicians |
| N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
46598 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 036655200 | 05 | |
| AZ | MEDICARE PTAN | Z154190 | 01 |
| AZ | 438736 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720110372 | Gregory James Novak | Optometrist | 3845 State St, Santa Barbara, CA 93105-3111 | 2007-03-09 |
| 1558870956 | Gregory Novak | Pharmacist | 315 S Manning Blvd, Albany, NY 12208-1707 | 2017-09-28 |
| 1124383823 | Gregory Charles Novak | Case Manager/Care Coordinator | 2789 Ortiz Ave, Building C, Fort Myers, FL 33905-7806 | 2012-07-09 |
| Street Address |
269 S CANDY LN |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326-4158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356345383 | Eugene M.r. Charlebois | Emergency Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2005-06-08 |
| 1306463740 | Riley Benjamin Johnson | Dietitian, Registered | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-07-01 |
| 1821619891 | Joshua Thomas Haywood | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-30 |
| 1396364162 | Jeremy Schmoyer | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-13 |
| 1144849993 | Miranda Rose Anderson | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-12 |
| 1659900876 | Eddie Khav | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4170 | 2020-04-08 |
| 1790314961 | Michelle Anne Pope | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-08 |
| 1699320390 | Emily Kathryn Danca | Dietitian, Registered | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-08-08 |
| 1760036909 | Tarra Denise Young | Nurse Practitioner | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-07-25 |
| 1275195950 | Samer Saeed Hasson | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-07-02 |
| 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 | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699033407 | Northern Arizona Healthcare Provider Group, LLC | Pathology | 269 South Candy Lane, Cottonwood, AZ 86326-4158 | 2012-04-30 |
| 1780821074 | Verde Valley Medical Center | Pathology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2009-01-08 |
| 1366505364 | Mark E Miller | Pathology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2006-12-19 |
| 1356323232 | Anna Pacelli | Pathology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200632 | Eric David Peters | Pathology | 11545 E Quiet Valley Pl, Tucson, AZ 85749-8884 | 2020-09-17 |
| 1609434794 | Peak Diagnostic Services LLC | Pathology | 3033 N 44th St Ste 200, Phoenix, AZ 85018-7244 | 2019-06-03 |
| 1144638008 | Michael Moore | Pathology | 8796 N Western Red Cedar Dr, Tucson, AZ 85743-7146 | 2014-07-23 |
| 1356683155 | Belinda Liu Sun | Pathology | 1501 N Campbell Ave Rm 5205, Tucson, AZ 85724-7232 | 2013-03-20 |
| 1669717815 | Guadalupe Hortencia Manriquez | Pathology | 7601 N Calle Sin Envidia, 31, Tucson, AZ 85718-1271 | 2012-11-29 |
| 1407164486 | Aztec Pathology LLC | Pathology | 2538 E University Dr Ste 100, Phoenix, AZ 85034-6925 | 2010-09-23 |
| 1336471846 | Peter Salomon | Pathology | 6344 E Miramar Dr, Tucson, AZ 85715-3115 | 2010-02-08 |
| 1427387372 | Meryl Harold Haber | Pathology | 8464 E Charter Oak Dr, Scottsdale, AZ 85260-5315 | 2009-12-23 |
| 1538492400 | Paul Boschen Visconti | Pathology | 33619 N 79th Way, Scottsdale, AZ 85266-4241 | 2009-09-10 |
| 1417186305 | Brent J Bedke | Pathology | 1740 Sycamore Ave Ste C, Kingman, AZ 86409-1039 | 2009-07-13 |
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| 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.