DR. CHARLES TYLER REIDHEAD (NPI# 1912913716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912913716 |
| Entity Type | Individual |
| Full Name | DR. CHARLES TYLER REIDHEAD |
| Other Name | C TY REIDHEAD |
| Credential | M.D. |
| Practice Address |
200 W. Hospital Drive Whiteriver AZ 85941 |
| Mailing Address |
Po Box 860 Whiteriver AZ 85941-0860 |
| Practice Telephone | 9283384911 |
| Practice Fax Number | 9283381122 |
| Mailing Telephone | 9283384911 |
| Mailing Fax Number | 9283381122 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-12-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 25107 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 1629236716 | 05 | |
| AZ | 1871523191 | 05 | |
| AZ | 1780614008 | 05 | |
| AZ | 409856 | 05 | |
| AZ | 1295993376 | 05 |
| Street Address |
200 W. HOSPITAL DRIVE |
| City | WHITERIVER |
| State | AZ |
| Zip Code | 85941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942214366 | Tammie Jayne Gibson | Dentist | 200 W. Hospital Drive, Whiteriver, AZ 85941-0860 | 2006-07-28 |
| 1588111033 | Kristen Parker | Pharmacist | 200 W. Hospital Drive, Whiteriver, AZ 85941 | 2016-09-01 |
| 1770039059 | Laura Mary Close | Nurse Practitioner | 200 W. Hospital Drive, Whiteriver, AZ 85941 | 2016-08-28 |
| 1154601466 | Kerri Dowgiallo | Registered Nurse | 200 W. Hospital Drive, Whiteriver, AZ 85942 | 2011-08-18 |
| 1578870614 | Hillary Leigh Volsteadt | Pharmacist | 200 W. Hospital Drive, Whiteriver, AZ 85941 | 2010-09-10 |
| 1588787246 | Naomi C Roeder | Dentist | 200 W. Hospital Drive, Whiteriver, AZ 85941 | 2007-04-09 |
| 1649372004 | Dianna Lynn Mahoney | Family Medicine | 200 W. Hospital Drive, Whiteriver, AZ 85941-0860 | 2006-09-05 |
| 1104832369 | Pattie Jean Malone | Family Medicine | 200 W. Hospital Drive, Whiteriver, AZ 85941 | 2006-07-31 |
| 1831105998 | Janelle Eiko Brown | Pediatrics | 200 W. Hospital Drive, Whiteriver, AZ 85941 | 2006-07-31 |
| 1073529145 | Richard John Robinson | Podiatrist | 200 W. Hospital Drive, Whiteriver, AZ 85941 | 2006-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649816778 | Benjamin Robert Bishop | Pharmacist | 200 W Hospital Road, Whiteriver, AZ 85941 | 2019-11-25 |
| 1750922308 | Christal A Brewer | Specialist/Technologist | 1 N 1st Ave, Whiteriver, AZ 85941 | 2019-10-04 |
| 1154880862 | Ivan Atole IIi | Counselor | 302 W Ponderosa St, Whiteriver, AZ 85941 | 2019-03-13 |
| 1912456732 | Jamie Baha | Counselor | 302 West Ponderosa Street, White River, AZ 85941 | 2016-09-22 |
| 1891243382 | Donna Mauree Stevens | Counselor | 302 W. Ponderosa St., Whiteriver, AZ 85941 | 2016-09-14 |
| 1811445307 | Aura Josefina Ortiz | Counselor | 302 W Ponderosa Street, Whiteriver, AZ 85941 | 2016-09-14 |
| 1891152567 | White Mountain Apache Tribe Fire and Rescue | Ambulance | 612 S. Chief Ave, Whiteriver, AZ 85941 | 2016-01-26 |
| 1528450855 | Carla Francis Turrentine | Social Worker | 249 West Ponderosa Street, Whiteriver, AZ 85941 | 2015-02-24 |
| 1477890390 | Muhammad Kanakri | Pharmacist | 200 West Whiteriver, Usphs Indian Hospital, Whitriver, AZ 85941 | 2013-01-11 |
| 1871870980 | Kathleen Wynn | Registered Nurse | 400 Apache Drive, Whiteriver, AZ 85941 | 2011-11-03 |
| Find all providers in zip 85941 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive 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 |
|---|---|---|---|---|
| 1861887226 | Hana Bakalli | Internal Medicine | 200 W Hospital Drive, Whiteriver, AZ 85941 | 2015-04-02 |
| 1972692028 | Susan Vest | Internal Medicine | 200 West Hospital Drive, Whiteriver, AZ 85941-0860 | 2006-10-12 |
| 1649285446 | Matthew Kevin Rydberg | Internal Medicine | 200 West Hospital Drive, Whiteriver, AZ 85941 | 2006-07-30 |
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| Find all providers with the same taxonomy | ||||
| City | WHITERIVER |
| Zip Code | 85941 |
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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.