CORY MATTHEW GINGOLD (NPI# 1679512198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679512198 |
| Entity Type | Individual |
| Full Name | CORY MATTHEW GINGOLD |
| Credential | PA |
| Practice Address |
1000 N Humphreys St Suite 104 Flagstaff AZ 86001-3136 |
| Mailing Address |
2550 N Thunderbird Cir Ste 303 Mesa AZ 85215-1214 |
| Practice Telephone | 9287793844 |
| Practice Fax Number | 9287793848 |
| Mailing Telephone | 4804359132 |
| Mailing Fax Number | 4807760025 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-05-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
2243 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 532433 | 05 |
| Street Address |
1000 N HUMPHREYS ST SUITE 104 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942748132 | Erin Leann Felicetti | Dietitian, Registered | 1000 N Humphreys St, Suite 210, Flagstaff, AZ 86001-3136 | 2017-02-07 |
| 1245664887 | Sherry Walka | Nurse Practitioner | 1000 N Humphreys St, Flagstaff, AZ 86001-3136 | 2013-08-31 |
| 1326354440 | Troyer Urgent Care, Inc. | Clinic/Center | 1000 N Humphreys St, Suite 104, Flagstaff, AZ 86001-3136 | 2010-08-26 |
| 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 | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750476685 | Rachelle M Tognacci | Emergency Medicine | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528679354 | Arizona Hospitalists, Pllc | Emergency Medicine | 10255 N 43rd St, Phoenix, AZ 85028-4108 | 2020-08-14 |
| 1154898435 | Phoenix Physician Group, LLC | Emergency Medicine | 3430 N. Mountain Ridge, Unit 14, Mesa, AZ 85207 | 2018-10-25 |
| 1205328382 | Darren Keith Johnson | Emergency Medicine | 601 El Dorado St, Kingman, AZ 86401-6224 | 2018-06-04 |
| 1396259636 | Fire Medical Billing, LLC | Emergency Medicine | 207 N Gilbert Rd Ste 1, Gilbert, AZ 85234-5812 | 2017-11-22 |
| 1427570753 | Buckskin Fire District | Emergency Medicine | 8500 Riverside Dr, Parker, AZ 85344-7001 | 2017-07-07 |
| 1699040824 | Jennifer Leigh Hissett | Emergency Medicine | Corner of Route N 7 and N 12, Fort Defiance, AZ 86504-0589 | 2012-03-21 |
| 1649478967 | Genna M Cammarata | Emergency Medicine | 36050 N 58th St, Cave Creek, AZ 85331-9162 | 2007-07-09 |
| 1861566226 | Peggy Jean Englebrake | Emergency Medicine | Hwy 160 163, Building Ka2010, Kayenta, AZ 86033-0368 | 2006-11-20 |
| 1285708172 | William Fowler Fulton Jr. | Emergency Medicine | 2557 S Val Vista Dr, Gilbert, AZ 85295-6229 | 2006-11-20 |
| 1477641991 | Lincoln Physician Billing, LLC | Emergency Medicine | 2500 W Utopia Rd Ste 100, Phoenix, AZ 85027-4172 | 2006-10-10 |
| Find all providers with the same taxonomy | ||||
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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.