PRESCOTT GASTROENTEROLOGY (NPI# 1720110984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720110984 |
| Entity Type | Organization |
| Organization Name | PRESCOTT GASTROENTEROLOGY |
| Other Organization Name | PRESCOTT GASTROENTEROLOGY CONSULTANTS MEDICAL GROUP |
| Practice Address |
811 Ainsworth Dr Ste 103 Prescott AZ 86301-1687 |
| Practice Telephone | 9287715548 |
| Practice Fax Number | 9287715549 |
| Mailing Telephone | 9287715548 |
| Mailing Fax Number | 9287715549 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2010-08-27 |
| Authorized Official Name | MRS. DEBBIE MARIE DE LUNA (OFFICE MANAGER) |
| Authorized Official Telephone | 9287715548 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
22747 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 176950 | 05 |
| Other Name | Type Code |
|---|---|
| Prescott Gastroenterology Consultants Medical Group | Other Name - Individual/Organization |
| Street Address |
811 AINSWORTH DR STE 103 |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-1687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861478299 | William Lockwood | Internal Medicine | 811 Ainsworth Dr Ste 103, Prescott, AZ 86301-1687 | 2005-12-18 |
| 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 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720156136 | Edmundo Samuel Justino | Internal Medicine | 810 Ainsworth Dr Ste A, Prescott, AZ 86301-1612 | 2006-12-01 |
| 1194700914 | Richard Pleva | Internal Medicine | 5350 Distinction Way, Prescott, AZ 86301-8418 | 2005-12-14 |
| 1598229593 | Tri-city Gastroenterology Plc | Internal Medicine | 5350 Distinction Way, Prescott, AZ 86301-8418 | 2019-01-24 |
| 1285824664 | Richard Pleva | Internal Medicine | 5350 Distinction Way, Prescott, AZ 86301-8418 | 2007-07-31 |
| 1295943660 | Rukshana N Cader | Internal Medicine | 810 Ainsworth Dr Ste A, Prescott, AZ 86301-1612 | 2007-05-18 |
| 1881795052 | Ching C. Wang | Internal Medicine | 5350 Distinction Way, Prescott, AZ 86301-8418 | 2006-09-26 |
| 1003822875 | Mark Thomas Worthington | Internal Medicine | 810 Ainsworth Dr, Prescott, AZ 86301-1612 | 2006-07-31 |
| 1255319877 | Peter C Witt | Internal Medicine | 811 Ainsworth Dr, Ste. 103, Prescott, AZ 86301-1687 | 2006-01-04 |
| 1104802628 | Milton Murray Schild | Internal Medicine | 811 Ainsworth Dr, Suite 103, Prescott, AZ 86301-1687 | 2005-12-16 |
| 1174508998 | Ljudevit Andres | Internal Medicine | 811 Ainsworth Dr, Suite 103, Prescott, AZ 86301-1687 | 2005-12-14 |
| 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.