PRESCOTT VAMC (NPI# 1770539561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770539561 |
| Entity Type | Organization |
| Organization Name | PRESCOTT VAMC |
| Other Organization Name | KINGMAN VA CBOC |
| Practice Address |
2668 Hualapai Mountain Rd Kingman AZ 86401-8387 |
| Mailing Address |
Po Box 94411 Cleveland OH 44101-4411 |
| Practice Telephone | 7023413152 |
| Mailing Telephone | 7023413152 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2017-11-01 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Kingman VA CBOC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558759837 | Prescott Vamc | Clinic/Center | 33 West Vista Drive, Holbrook, AZ 86025-1844 | 2015-01-08 |
| 1356739650 | Prescott Vamc | Clinic/Center | 801 North Navajo Drive, Suite B, Page, AZ 86040-9998 | 2015-01-08 |
| 1952345076 | Prescott Vamc | Clinic/Center | 1300 W University Ave, #200, Flagstaff, AZ 86001-7214 | 2006-06-16 |
| 1477505493 | Prescott Vamc | Clinic/Center | 501 S Willard St, Cottonwood, AZ 86326-8120 | 2006-05-17 |
| 1477504975 | Prescott Vamc | Clinic/Center | 41810 N Venture Dr Bldg B, Anthem, AZ 85086-3169 | 2006-05-12 |
| 1275583684 | Prescott Vamc | General Acute Care Hospital | 500 N Highway 89, Prescott, AZ 86313-5001 | 2006-05-10 |
| 1801854328 | Prescott Vamc | Department of Veterans Affairs (VA) Pharmacy | 500 N Hwy 89, Prescott, AZ 86313-5001 | 2006-05-03 |
| 1669857975 | Prescott Vamc | Clinic/Center | Highway 264, Mile Post 388, Polacca, AZ 86042-9998 | 2015-07-28 |
| 1184009490 | Prescott Vamc | Clinic/Center | Us Highway 160, Kayenta, AZ 86033-9998 | 2015-07-28 |
| 1891183182 | Prescott Vamc | Clinic/Center | Highway 191 and Hospital Drive, Chinle, AZ 86503-9998 | 2015-01-08 |
| Street Address |
2668 HUALAPAI MOUNTAIN RD |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401-8387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013382613 | Melissa Faye Durden | Social Worker | 2668 Hualapai Mountain Rd, Kingman, AZ 86401-8387 | 2015-12-08 |
| 1912394685 | David A D'auteuil | Social Worker | 2668 Hualapai Mountain Rd, Kingman, AZ 86401 | 2015-04-21 |
| 1376931212 | Alexis Kaye Stewart | Social Worker | 2668 Hualapai Mountain Rd, Kingman Cboc, Kingman, AZ 86401 | 2014-12-30 |
| 1568863868 | Susan Browning | Registered Nurse | 2668 Hualapai Mountain Rd, Kingman, AZ 86401-8387 | 2014-09-06 |
| 1457751125 | Nathan Rosato | Social Worker | 2668 Hualapai Mountain Rd, Kingman, AZ 86401-8387 | 2014-08-29 |
| 1942610217 | Jolene Cook | Social Worker | 2668 Hualapai Mountain Rd, Kingman, AZ 86401-8387 | 2014-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
| 1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
| 1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
| 1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
| 1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
| 1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
| 1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
| 1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
| 1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
| 1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
| Find all providers in zip 86401 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013457704 | Tucson Vamc | Clinic/Center | 1179 E Cottonwood Lane, Suite 1, Casa Grande, AZ 85122-2969 | 2017-03-01 |
| 1104366897 | Tucson Vamc | Clinic/Center | 157 North Coronado Drive, Suite B, Sierra Vista, AZ 85635-6361 | 2017-03-01 |
| 1619352077 | Phoenix Vamc | Clinic/Center | 1500 East Thomas Road, Suite 106, Phoenix, AZ 85014-5748 | 2015-07-28 |
| 1558759837 | Prescott Vamc | Clinic/Center | 33 West Vista Drive, Holbrook, AZ 86025-1844 | 2015-01-08 |
| 1356739650 | Prescott Vamc | Clinic/Center | 801 North Navajo Drive, Suite B, Page, AZ 86040-9998 | 2015-01-08 |
| 1265785364 | Phoenix Vamc | Clinic/Center | 11390 East Via Linda Road, Suite 105, Scottsdale, AZ 85259-4075 | 2012-10-26 |
| 1033345624 | Phoenix Vamc | Clinic/Center | 9424 N 25th Ave, Phoenix, AZ 85021-2714 | 2009-06-09 |
| 1811176530 | Cthvamc | Clinic/Center | 239 W Utopia Rd, Phoenix, AZ 85027-4738 | 2007-10-30 |
| 1952345076 | Prescott Vamc | Clinic/Center | 1300 W University Ave, #200, Flagstaff, AZ 86001-7214 | 2006-06-16 |
| 1235173931 | Tucson Vamc | Clinic/Center | 101 N Coronado Dr Ste A, Building 45006, Sierra Vista, AZ 85635-6359 | 2006-06-15 |
| 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.