PONDEROSA FAMILY CARE, LLC (NPI# 1992321723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992321723 |
| Entity Type | Organization |
| Organization Name | PONDEROSA FAMILY CARE, LLC |
| Practice Address |
127 E Main St Ste D Payson AZ 85541-5646 |
| Mailing Address |
Po Box 2901 Payson AZ 85547-2901 |
| Practice Telephone | 9284688603 |
| Practice Fax Number | 9284688625 |
| Mailing Telephone | 9284688603 |
| Mailing Fax Number | 9284688625 |
| Enumeration Date | 2020-06-17 |
| Last Update Date | 2020-06-17 |
| Authorized Official Name | DR. ALAN P MICHELS (PHYSICIAN/OWNER) |
| Authorized Official Telephone | 9284688603 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144535626 | Ponderosa Family Care, LLC | Pediatrics | 806 S Ponderosa St, Payson, AZ 85541-5541 | 2010-08-09 |
| Street Address |
127 E MAIN ST STE D |
| City | PAYSON |
| State | AZ |
| Zip Code | 85541-5646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447805130 | Melissa Marie Avery | Registered Nurse | 903 Az-260, Payson, AZ 85541 | 2019-08-08 |
| 1952803710 | Payson Orthodontics | Dentist | 902 S Beeline Hwy, Payson, AZ 85541 | 2018-03-07 |
| 1568844181 | Banner Home Care Arizona | Home Health | 708 E Route 260 Ste A1, Payson, AZ 85541 | 2015-06-19 |
| 1063893626 | Sage Counseling, Inc. | Community/Behavioral Health | 1100 N. Beeline Hwy, Suite F, Payson, AZ 85541 | 2015-06-09 |
| 1053712059 | Garry Gordon | Homeopath | 600 N Beeline Hwy, Payson, AZ 85541 | 2014-09-09 |
| 1821406901 | Monica Nestich | Physical Therapy Assistant | 708 E. State Hwy 260, Payson, AZ 85541 | 2014-08-01 |
| 1841601523 | Megan Fragale Saalfrank | Pharmacist | 401 E. Highway 260, Payson, AZ 85541 | 2014-05-15 |
| 1750791836 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 600 E. Highway 260, Suite 4 & 5, Payson, AZ 85541 | 2014-04-29 |
| 1164775169 | Kc's Home Health Care LLC of Payson | Home Health | 114 E. Highway 260, Payson, AZ 85541 | 2012-10-16 |
| 1598014458 | Ivan D. Mclaws, Dpm | Podiatrist | 200 East Lone Pine Dr., Payson, AZ 85541 | 2012-09-06 |
| Find all providers in zip 85541 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1447865654 | San Luis Walk-in Clinic, Inc. | Clinic/Center | 151 S Oak Ave Ste 3, San Luis, AZ 85336-0756 | 2020-09-14 |
| 1457966657 | San Luis Walk-in Clinic, Inc. | Clinic/Center | 151 S Oak Ave Ste 5, San Luis, AZ 85336-0756 | 2020-09-14 |
| 1770097123 | Community Hospital Association, Inc. | Clinic/Center | 32919 N Center St Ste B, Wittmann, AZ 85361-9433 | 2017-11-21 |
| 1720433832 | Parker Medical Center, Ltd | Clinic/Center | 905 S Fiesta Ave, Parker, AZ 85344-5152 | 2016-04-26 |
| 1386904019 | Mz Trans | Clinic/Center | 8603 N 22nd Ave Apt 134, Phoenix, AZ 85021 | 2012-05-29 |
| 1497021844 | Cobre Valley Regional Medical Center | Clinic/Center | 124 N Tewskbury Blvd, Young, AZ 85554-0000 | 2012-03-30 |
| 1609144393 | Community Hospital Association, Inc. | Clinic/Center | 26750 S. Santa Fe Road, Suite B, Congress, AZ 85332 | 2011-12-08 |
| 1285869883 | Rchp-sierra Vista Inc | Clinic/Center | 1101 N San Antonio Ave, Douglas, AZ 85607-2419 | 2009-05-27 |
| 1467695296 | Community Bridges, Inc | Clinic/Center | 995 Hermosa Drive, Holbrook, AZ 86025 | 2009-04-09 |
| 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.