KINGMAN HEALTHCARE, INC (NPI# 1538347836) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538347836 |
| Entity Type | Organization |
| Organization Name | KINGMAN HEALTHCARE, INC |
| Other Organization Name | KINGMAN REGIONAL MEDICAL CENTER HOSPICE |
| Practice Address |
3269 Stockton Hill Rd Kingman AZ 86409-3619 |
| Practice Telephone | 9287570626 |
| Practice Fax Number | 9286922706 |
| Mailing Telephone | 9287570626 |
| Mailing Fax Number | 9286922706 |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2020-07-02 |
| Authorized Official Name | TIM BLANCHARD (CFO) |
| Authorized Official Telephone | 9286818668 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251G00000X | Hospice Care, Community Based | HSPC4872 | AZ | Agencies |
| Y | 251G00000X | Hospice Care, Community Based | SPC3040 | AZ | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | BCBS | P0702260 | 01 |
| AZ | 722878 | 05 |
| Other Name | Type Code |
|---|---|
| Kingman Hospital, Inc | Former Legal Business Name - Organization |
| Kingman Regional Medical Center Hospice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760703805 | Kingman Healthcare, Inc | Clinic/Center | 1726 E Beverly Ave Ste A, Kingman, AZ 86409-3500 | 2010-06-11 |
| 1174701478 | Kingman Healthcare, Inc | Home Health | 2202 N Stockton Hill Rd Ste 200, Kingman, AZ 86401-4622 | 2008-02-08 |
| 1992286298 | Kingman Healthcare, Inc | Pharmacy | 1739 E Beverly Ave Ste 106, Kingman, AZ 86409-3593 | 2018-08-24 |
| 1184802480 | Kingman Healthcare, Inc | General Acute Care Hospital | 3801 Santa Rosa Dr, Kingman, AZ 86401-2311 | 2008-02-08 |
| 1689897787 | Kingman Healthcare, Inc | Family Medicine | 1739 Beverly Avenue, Suite 200, Kingman, AZ 86409-3593 | 2007-04-10 |
| 1265423917 | Kingman Healthcare, Inc | Home Health | 3269 N Stockton Hill Rd, Kingman, AZ 86409-3619 | 2005-11-02 |
| Street Address |
3269 STOCKTON HILL RD |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86409-3619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578527347 | Jeffrey J Lunn | Anesthesiology | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2006-04-17 |
| 1952765281 | Jonathon Allen Sexton | Student in an Organized Health Care Education/Training Program | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2016-04-13 |
| 1669836284 | Justina Truong | Emergency Medicine | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2016-04-09 |
| 1861854085 | Amina Danishyar | Emergency Medicine | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2016-03-26 |
| 1831555184 | Jill Kristen Lacson | Occupational Therapy Assistant | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2015-12-31 |
| 1417324534 | Bradley Fox | Nurse Practitioner | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2015-08-24 |
| 1285016394 | Wyatt Randolph Eddy | Physician Assistant | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2015-06-25 |
| 1700266350 | Dana Rose-saulibio Bowers | Pharmacist | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2015-06-08 |
| 1538554746 | Jayson Malufau | Family Medicine | 3269 Stockton Hill Rd, Kingman, AZ 86409 | 2015-04-03 |
| 1033504360 | Brian Jahnny | Emergency Medicine | 3269 Stockton Hill Rd, Kingman, AZ 86409-3619 | 2015-04-02 |
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| 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 | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477009371 | Best Hospice LLC | Hospice Care, Community Based | 1740 Beverly # B, Kingman, AZ 86401-3564 | 2016-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677224 | In My Home Hospice Care | Hospice Care, Community Based | 1204 E Baseline Rd Ste 101, Tempe, AZ 85283-1447 | 2020-10-23 |
| 1295334282 | Aventus Hospice Care Inc | Hospice Care, Community Based | 1 S Church Ave # 12001253, Tucson, AZ 85701-1612 | 2020-10-20 |
| 1659970648 | Avra Hospice Care Inc | Hospice Care, Community Based | 1 S Church Ave # 12001255, Tucson, AZ 85701-1612 | 2020-10-20 |
| 1437758885 | Legacy Hospice Care LLC | Hospice Care, Community Based | 7725 N 43rd Ave Ste 611, Phoenix, AZ 85051-5770 | 2020-10-17 |
| 1396351235 | Catalina Hospice | Hospice Care, Community Based | 225 W Ajo Way, Tucson, AZ 85713-6038 | 2020-09-16 |
| 1588279673 | Centra Management Services LLC | Hospice Care, Community Based | 4530 E Shea Blvd Ste 142, Phoenix, AZ 85028-6067 | 2020-09-15 |
| 1407461643 | Kind Hearts Hospice, Inc. | Hospice Care, Community Based | 10210 N 32nd St Ste 215, Phoenix, AZ 85028-3848 | 2020-09-14 |
| 1104435379 | Nana Hope Hospice North LLC | Hospice Care, Community Based | 609 W Gurley St Ste 1, Prescott, AZ 86305-3619 | 2020-07-23 |
| 1104434141 | First Choice Hospice LLC | Hospice Care, Community Based | 1738 E Thomas Rd, Phoenix, AZ 85016-7604 | 2020-07-15 |
| 1538787122 | Nana Hope Hospice and Palliative Care LLC | Hospice Care, Community Based | 1620 N 48th St Ste 101, Phoenix, AZ 85008-7720 | 2020-07-09 |
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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.