MS. MARIA THERESE BOEDIGHEIMER (NPI# 1609862275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609862275 |
| Entity Type | Individual |
| Full Name | MS. MARIA THERESE BOEDIGHEIMER |
| Credential | PA C |
| Practice Address |
3120 Clearwater Dr Prescott AZ 86305-7131 |
| Mailing Address |
Po Box 10880 Prescott AZ 86304-0880 |
| Practice Telephone | 9287713704 |
| Practice Fax Number | 9287710434 |
| Mailing Telephone | 9287595987 |
| Mailing Fax Number | 9284582039 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2017-02-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 4435 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 85000971 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 927112 | 05 | |
| AZ | AZ LICENSE | 4435 | 01 |
| Street Address |
3120 CLEARWATER DR |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86305-7131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801100250 | Kenneth G. Lawlor, Do, Pllc | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2010-07-27 |
| 1255582003 | Yavapai Regional Medical Center Physician Care LLC | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2008-10-09 |
| 1396919387 | Yrmc Physiciancare Internal Medicine | Clinic/Center | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2008-04-22 |
| 1982796686 | David Paul Danowski | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2006-09-29 |
| 1154420180 | Anthony V Torres | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2006-09-22 |
| 1265538235 | Nicholas H Rice | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2006-09-16 |
| 1326072000 | Allen Richard Gardner | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2006-07-10 |
| 1437101789 | Marc H Brickman | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2006-05-16 |
| 1619964061 | Doreen Ann Slabaugh | Internal Medicine | 3120 Clearwater Dr, Prescott, AZ 86305-7131 | 2005-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005395 | Granite View Adult Care Home LLC | Assisted Living Facility | 7105 Williamson Valley Road, Prescott, AZ 86305 | 2018-03-01 |
| 1215468095 | Valerie Williams | Occupational Therapist | 926 S. Hinman Dr., Prescott, AZ 86305 | 2017-03-23 |
| 1174073837 | Caspian Gleam Medical Center LLC | Clinic/Center | 3130 Stillwater Drive, Suite B, Prescott, AZ 86305 | 2016-10-06 |
| 1114388634 | Marla Beth Perkins | Speech-Language Pathologist | 3160 Stillwater Dr., Prescott, AZ 86305 | 2016-03-10 |
| 1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1215351259 | Stefanie Maneval | Registered Nurse | 900 Iron Springs Rd, Prescott, AZ 86305 | 2014-02-11 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1871857359 | Neal Herbert Segovia Cabaluna | Internal Medicine | 3773 Crossings Dr Ste C, Prescott, AZ 86305 | 2012-06-28 |
| Find all providers in zip 86305 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598046070 | Landon Keith Stribe | Physician Assistant | 726 Gail Gardner Way Ste B, Prescott, AZ 86305-2316 | 2011-08-29 |
| 1841303690 | Samuel Clark Reid-mckee | Physician Assistant | Navahcs 500 North Hwy 89, Prescott, AZ 86313 | 2006-08-16 |
| 1922037431 | Dawn Annette Garcia | Physician Assistant | 3769 Crossings Dr Ste D, Prescott, AZ 86305-7121 | 2006-06-30 |
| 1962459040 | Kristine A Weaver-miller | Physician Assistant | 811 Ainsworth Dr Ste 109, Prescott, AZ 86301 | 2006-05-27 |
| 1952387813 | Karen Lynn Raffensperger | Physician Assistant | Medical Services of Prescott, 1003 Willow Creek Road, Prescott, AZ 86301 | 2005-12-21 |
| 1992708523 | Mark A Thiele | Physician Assistant | 1223 Willow Creek Rd, Prescott, AZ 86301-1427 | 2005-05-27 |
| 1376027540 | Lizette Leach | Physician Assistant | 3655 Crossings Dr, Prescott, AZ 86305-7101 | 2018-09-24 |
| 1215455886 | Madison Smith | Physician Assistant | 1090 Commerce Dr, Prescott, AZ 86305 | 2017-09-05 |
| 1245774397 | Stephen Green | Physician Assistant | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-12-08 |
| 1093258014 | Victoria Wood | Physician Assistant | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2016-11-22 |
| Find all providers in PRESCOTT | ||||
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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.