NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC (NPI# 1417215229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417215229 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC |
| Other Organization Name | VERDE VALLEY MEDICAL CLINIC: INFECTIOUS DISEASE |
| Practice Address |
450 S Willard St Cottonwood AZ 86326-6743 |
| Mailing Address |
1200 North Beaver Street Attn: Managed Care Contracting Flagstaff AZ 86001-3118 |
| Practice Telephone | 9286497991 |
| Mailing Telephone | 9282136543 |
| Mailing Fax Number | 9282143613 |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2019-04-16 |
| Authorized Official Name | RONALD F HAASE (NAH CHIEF SYSTEMS OFFICER) |
| Authorized Official Telephone | 9287732059 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHERN ARIZONA HEALTHCARE CORP. |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Verde Valley Medical Clinic: Infectious Disease | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417384371 | Northern Arizona Healthcare Provider Group, LLC | Optometrist | 1298 W Finnie Flat Rd # 101, Camp Verde, AZ 86322-5958 | 2013-10-08 |
| 1851659817 | Northern Arizona Healthcare Provider Group, LLC | Surgery | 199 South Candy Lane, Cottonwood, AZ 86326-4183 | 2012-04-27 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1386099869 | Northern Arizona Healthcare Provider Group, LLC | Anesthesiology | 1200 N. Beaver Street, Attn: Payer Credentialing, Flagstaff, AZ 86001-3118 | 2016-05-03 |
| 1295121903 | Northern Arizona Healthcare Provider Group, LLC | Obstetrics & Gynecology | 269 South Candy Lane, Flagstaff, AZ 86326 | 2015-04-09 |
| 1174914915 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2015-02-16 |
| 1699182188 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2014-07-16 |
| 1265846968 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2014-06-20 |
| 1740694470 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-06-20 |
| 1003230830 | Northern Arizona Healthcare Provider Group, LLC | Psychologist | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-02-14 |
| Street Address |
450 S WILLARD ST |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326-6743 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073515235 | Northern Arizona Rehabilitation & Fitness | Physical Therapist | 450 S Willard St, Ste 106, Cottonwood, AZ 86326-6744 | 2005-06-01 |
| 1669867719 | Maxwell John Matson | Internal Medicine | 450 S Willard St, Cottonwood, AZ 86326 | 2015-04-04 |
| 1518373901 | April Schleier | Nurse Practitioner | 450 S Willard St, Cottonwood, AZ 86326-6743 | 2014-07-07 |
| 1730511296 | Julia M Trainor | Nurse Practitioner | 450 S Willard St, Suite 115, Cottonwood, AZ 86326-6743 | 2013-08-06 |
| 1821330028 | Celeste Cheri Scalf | Nurse Practitioner | 450 S Willard St, Suite 115, Cottonwood, AZ 86326-6743 | 2013-03-26 |
| 1154689966 | Northern Arizona Healthcare Provider Group, LLC | Neuromusculoskeletal Medicine & OMM | 450 S Willard St, Cottonwood, AZ 86326-6743 | 2012-04-30 |
| 1174881973 | Northern Arizona Healthcare Provider Group, LLC | Orthopaedic Surgery | 450 S Willard St, Cottonwood, AZ 86326-6743 | 2012-04-30 |
| 1790058915 | Joshua Joseph Gibbons | Internal Medicine | 450 S Willard St, Suite 107, Cottonwood, AZ 86326-6743 | 2012-02-18 |
| 1205153699 | Corey Ellis Sonnett | Physician Assistant | 450 S Willard St, Suite 105, Cottonwood, AZ 86326-6743 | 2010-04-26 |
| 1134457666 | Verde Valley Medical Center | Orthopaedic Surgery | 450 S Willard St, Cottonwood, AZ 86326 | 2009-11-20 |
| 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 | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952332470 | Margaret F. Kobe | Internal Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2006-07-05 |
| 1356370571 | David W Keckich | Internal Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225658750 | Arizona Valley Infectious Diseases Plc | Internal Medicine | 13531 E Ocotillo Rd, Scottsdale, AZ 85259-2316 | 2020-04-24 |
| 1942695978 | Odero Consultants | Internal Medicine | 7000 N 16th St Ste 120, Phoenix, AZ 85020-5524 | 2015-04-07 |
| 1194026757 | John Gregory Corcoran | Internal Medicine | 5265 East Knight Drive, Tucson, AZ 85712 | 2010-11-12 |
| 1548574320 | Ahmad Mamdouh Ahmad Salameh | Internal Medicine | 13055 W Mcdowell Rd Ste E109, Avondale, AZ 85392-6457 | 2010-08-04 |
| 1194038505 | Logan Paolo Locsin Felix | Internal Medicine | 2001 W Orange Grove Rd Ste 404, Tucson, AZ 85704 | 2010-07-15 |
| 1942430418 | Nestor Varon Md PC | Internal Medicine | 29729 N 69th Ln, Peoria, AZ 85383-3185 | 2009-07-20 |
| 1780813725 | Georgiana Georgescu | Internal Medicine | 18301 N 79th Ave Ste C136, Glendale, AZ 85308-8471 | 2009-07-13 |
| 1811126303 | Sudha Nagalingam | Internal Medicine | 1230 S Cherrybell Stra, Tucson, AZ 85713-1907 | 2009-07-06 |
| 1417117920 | Michael Amoa Asare LLC | Internal Medicine | 3555 Val Vista Drvie, Mercy Gilbert Hospital, Gilbert, AZ 85296 | 2008-06-10 |
| 1154594695 | Joseph K Zachariah, Do, PC | Internal Medicine | 4723 E Desert Park Pl, Paradise Valley, AZ 85253-2949 | 2008-04-04 |
| Find all providers with the same taxonomy | ||||
| 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.