PRESCOTT RADIOLOGISTS LLP (NPI# 1689636243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689636243 |
| Entity Type | Organization |
| Organization Name | PRESCOTT RADIOLOGISTS LLP |
| Other Organization Name | PRESCOTT IMAGING CENTER |
| Practice Address |
1003 Willow Creek Rd Prescott AZ 86301-1641 |
| Mailing Address |
Po Box 678308 Dallas KS 75267-8308 |
| Practice Telephone | 9287781971 |
| Practice Fax Number | 9827715733 |
| Mailing Telephone | 9284452700 |
| Mailing Fax Number | 8006560593 |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2017-07-11 |
| Authorized Official Name | DR. MICHAEL J DANGELO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9287781971 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Prescott Imaging Center | Doing Business As Name - Organization |
| Street Address |
1003 WILLOW CREEK RD |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-1641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174528343 | Robert William Halterman | Family Medicine | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2005-06-15 |
| 1083211320 | Wendy E Nelson | Dietitian, Registered | 1003 Willow Creek Rd, Prescott, AZ 86301-1668 | 2020-10-08 |
| 1750909008 | Shawn Jeffery Mitchell | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2020-07-13 |
| 1669019683 | Justin Earl Rogers | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2019-12-09 |
| 1477116911 | Anna Mattson | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2019-04-19 |
| 1790276608 | Phillip Allen Schafer | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301 | 2018-05-25 |
| 1144724618 | Richard Barclay Thompson | Respiratory Therapist, Registered | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2018-03-20 |
| 1245774397 | Stephen Green | Physician Assistant | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-12-08 |
| 1427500107 | Zachary Archer | Perfusionist | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-10-28 |
| 1952753675 | Candice Panton | Nurse Practitioner | 1003 Willow Creek Rd, Prescott, AZ 86301-1641 | 2016-07-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
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| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255721684 | Ronald Lake II | Specialist | 807 Lizzard Ln, Prescott, AZ 86303-4517 | 2015-01-22 |
| 1962808220 | Karie Mangiardi-hammond | Specialist | 3160 Stillwater Dr, Prescott, AZ 86305-7151 | 2014-11-14 |
| 1649610999 | Cheryl A Rynd | Specialist | 1745 Rustic Timbers Ln, Suite D, Prescott, AZ 86303-4966 | 2013-07-01 |
| 1629416755 | Irene A. Hsieh | Specialist | 1820 Sequoia Dr, Prescott, AZ 86301-1245 | 2013-06-11 |
| 1235416918 | Gregg P Standage Md | Specialist | 705 W Hillside Ave, Prescott, AZ 86301-1938 | 2011-11-09 |
| 1467694901 | Kim Suzanne Plawchan | Specialist | 522 E. Sheldon St, Prescott, AZ 86301 | 2009-03-30 |
| 1699920207 | Mark Edwin Carli | Specialist | 3108 Clearwater Dr Ste B2, Prescott, AZ 86305-7170 | 2008-11-24 |
| 1922270438 | Karen L Yates Md PC | Specialist | 141 S Mccormick St Ste 108, Prescott, AZ 86303-4730 | 2008-03-25 |
| 1982880142 | Kathleen F Parker | Specialist | 4864 E Diamond Dr, Prescott, AZ 86301-5944 | 2008-01-17 |
| 1548469372 | Ben Eugene Paxton | Specialist | 1000 Ainsworth # 115, Prescott, AZ 86305 | 2007-07-12 |
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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.