NORTH COUNTRY HEALTHCARE, INC. (NPI# 1336329788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336329788 |
| Entity Type | Organization |
| Organization Name | NORTH COUNTRY HEALTHCARE, INC. |
| Practice Address |
1510 N Stockton Hill Rd Kingman AZ 86401 |
| Mailing Address |
Po Box 3630 Flagstaff AZ 86003-3630 |
| Practice Telephone | 9287531177 |
| Practice Fax Number | 9287531178 |
| Mailing Telephone | 9285229879 |
| Mailing Fax Number | 9285229880 |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2016-07-26 |
| Authorized Official Name | ANNE NEWLAND (CEO/CMO) |
| Authorized Official Telephone | 9285229576 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH COUNTRY HEALTHCARE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
AZ | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619345675 | North Country Healthcare, Inc. | Family Medicine | 1120 West University Avenue, Suite 101, Flagstaff, AZ 86001-3630 | 2015-09-08 |
| 1033454707 | North Country Healthcare, Inc. | Family Medicine | 2600 E. Show Low Lake Rd., Show Low, AZ 85901 | 2012-12-06 |
| 1750691788 | North Country Healthcare, Inc. | Clinic/Center | 301 S 7th Street, Williams, AZ 86045 | 2010-10-08 |
| 1760798680 | North Country Healthcare, Inc. | Clinic/Center | 2585 S. Miracle Mile, Ste 116, Bullhead, AZ 86442 | 2010-08-30 |
| 1073740098 | North Country Healthcare, Inc. | Clinic/Center | 2650 E. Show Low Lake Rd, Suite 1, Show Low, AZ 85901 | 2009-06-17 |
| 1033359468 | North Country Healthcare, Inc. | Clinic/Center | 2090 N. Smoketree Ave, Lake Havasu City, AZ 86403 | 2009-02-25 |
| 1235254475 | North Country Healthcare, Inc. | Clinic/Center | 22585 West Oak Street, Seligman, AZ 86337 | 2007-03-20 |
| 1275657363 | North Country Healthcare, Inc. | Clinic/Center | 620 W. Lee Street, Winslow, AZ 86047 | 2007-03-16 |
| 1790809879 | North Country Healthcare, Inc. | Clinic/Center | 488 S. Mountain Ave., Springerville, AZ 85938 | 2007-03-16 |
| 1649334442 | North Country Healthcare, Inc. | Pharmacy | 2920 North 4th Street, Flagstaff, AZ 86004 | 2006-12-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTH COUNTRY HEALTHCARE, INC. | 2920 N 4th St, Flagstaff, AZ 86004-1816 |
| Street Address |
1510 N STOCKTON HILL RD |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467079822 | Stephanie Dunajski | Family Medicine | 1510 N Stockton Hill Rd, Kingman, AZ 86401-5173 | 2020-07-01 |
| 1366957177 | Colleen Mary Mcweeney | Nurse Practitioner | 1510 N Stockton Hill Rd, Kingman, AZ 86401-5173 | 2017-12-04 |
| 1700309697 | Christopher Jarrell | Nurse Practitioner | 1510 N Stockton Hill Rd, Kingman, AZ 86401-5173 | 2017-07-21 |
| 1326418526 | Sean L'huillier Sr. | Nurse Practitioner | 1510 N Stockton Hill Rd, Kingman, AZ 86401-5173 | 2015-09-30 |
| 1992113906 | Jennifer Ann Kern | Clinical Nurse Specialist | 1510 N Stockton Hill Rd, Kingman, AZ 86401 | 2014-07-23 |
| 1982016697 | North Country Health Care | Clinic/Center | 1510 N Stockton Hill Rd, Kingman, AZ 86401-5173 | 2014-05-29 |
| 1831407865 | Judith Mary Lassen | Nurse Practitioner | 1510 N Stockton Hill Rd, Kingman, AZ 86401 | 2010-09-24 |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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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.