NORTHERN ARIZONA HEALTHCARE CORPORATION (NPI# 1639545007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639545007 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE CORPORATION |
| Practice Address |
1200 N Beaver St Flagstaff AZ 86001-3118 |
| Mailing Address |
510 E Twelve Oaks Dr Flagstaff AZ 86005-7063 |
| Practice Telephone | 9287793366 |
| Mailing Telephone | 4802095960 |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |
| Authorized Official Name | COLLEEN LITTLE (CLINICAL MANAGER) |
| Authorized Official Telephone | 9287793366 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP8048 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669914552 | Northern Arizona Healthcare Corporation | Psychiatry & Neurology | 1200 N. Beaver Street, Attn: Payer Credentialing, Flagstaff, AZ 86001-3118 | 2016-11-09 |
| 1730110925 | Northern Arizona Healthcare Corporation | Hospice Care, Community Based | 203 S Candy Ln, Cottonwood, AZ 86326-4120 | 2006-07-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHERN ARIZONA HEALTHCARE CORPORATION | 1200 N Beaver St, Flagstaff, AZ 86001-3118 |
| Street Address |
1200 N BEAVER ST |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346241189 | Alvin B Elisco | Internal Medicine | 1200 N Beaver St, Fmc Hospitalists, Flagstaff, AZ 86001-3118 | 2005-08-02 |
| 1285240515 | Amika Noel | Nurse Anesthetist, Certified Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-09-22 |
| 1669084190 | Margaret Grace Mcgough | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-08-17 |
| 1942818398 | Regan Rowson | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-07-21 |
| 1871118984 | Nancy Gloria Flores | Audiologist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-06-15 |
| 1679100705 | Kristy Anderson | Occupational Therapist | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-26 |
| 1164058087 | Bryan J Ebeling | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2020-03-23 |
| 1447808407 | Bryce Aldworth Randall | Registered Nurse | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-09-03 |
| 1851952162 | Samuel Small | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-26 |
| 1235797283 | Rebecca R Boger | Dietitian, Registered | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326408527 | Taye Nelson | Nurse Practitioner | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2016-03-01 |
| 1518309350 | Jeremy K Burdick | Nurse Practitioner | 1501 S Yale St, 252, Flagstaff, AZ 86001-7304 | 2013-07-22 |
| 1255480422 | Katherine Dolan Watkins | Nurse Practitioner | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2007-01-09 |
| 1518023167 | Diana E Holt | Nurse Practitioner | 107 E Oak Ave, 101, Flagstaff, AZ 86001-1818 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961425 | Christian Reese Newsom | Nurse Practitioner | 6980 E Sahuaro Dr Apt 1085, Scottsdale, AZ 85254-5295 | 2020-10-29 |
| 1083258354 | Stephenie Ann Lechuga | Nurse Practitioner | 3415 W Glendale Ave Ste 32a, Phoenix, AZ 85051-8485 | 2019-10-30 |
| 1821650201 | Rebekah Ellen Charry | Nurse Practitioner | 115 Calle Portal Ste 700, Sierra Vista, AZ 85635-2950 | 2019-07-05 |
| 1326606146 | Mollie Finn | Nurse Practitioner | 2356 N Emerald Lake Ct, Tucson, AZ 85749-7925 | 2019-06-05 |
| 1134698160 | Kayla Rose Percy | Nurse Practitioner | 1205 N F Ave, Douglas, AZ 85607-1920 | 2018-11-20 |
| 1063987683 | Katherine Anne Bassler | Nurse Practitioner | 5375 E Erickson Dr Ste 103, Tucson, AZ 85712-2838 | 2018-10-10 |
| 1134613607 | Brittany Kunz | Nurse Practitioner | 2456 E Fairview Cir, Mesa, AZ 85204-5421 | 2018-06-19 |
| 1124526884 | Kidnurse, LLC | Nurse Practitioner | 1550 S Alma School Rd Ste 275, Mesa, AZ 85210-2107 | 2018-01-29 |
| 1407354244 | Mariah Karyn White | Nurse Practitioner | 13065 W Mcdowell Rd Ste C130, Avondale, AZ 85392-6448 | 2018-01-26 |
| 1750890075 | West Valley Pediatrics | Nurse Practitioner | 10750 West Mcdowell Rd, Suite G700, Avondale, AZ 85392 | 2017-09-29 |
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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.