MARK R MOURITSEN (NPI# 1033120712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033120712 |
| Entity Type | Individual |
| Full Name | MARK R MOURITSEN |
| Credential | MD |
| Practice Address |
2585 E Wilcox Dr Suite A Sierra Vista AZ 85635-2821 |
| Mailing Address |
6 South Second Street Sierra Vista AZ 85635-2821 |
| Practice Telephone | 5204598990 |
| Practice Fax Number | 5204520379 |
| Mailing Telephone | 5204584335 |
| Mailing Fax Number | 5204582988 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 28909 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 589343 | 05 |
| Street Address |
2585 E WILCOX DR SUITE A |
| City | SIERRA VISTA |
| State | AZ |
| Zip Code | 85635-2821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134398340 | Arizona Family Care Associates Urgent Care Clinic, LLC | Durable Medical Equipment & Medical Supplies | 2585 E Wilcox Dr, Suite A, Sierra Vista, AZ 85635 | 2008-02-22 |
| 1780813832 | Douglas A Simmons | Nurse Practitioner | 2585 E Wilcox Dr, Mark A Kaplan Pllc, Suite C, Sierra Vista, AZ 85635-2821 | 2009-07-10 |
| 1548436603 | Pamela Gail Enright | Nurse Practitioner | 2585 E Wilcox Dr, Suite A, Sierra Vista, AZ 85635-2821 | 2008-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740640 | Taylor Anne Phelps | Student in an Organized Health Care Education/Training Program | Haven of Sierra Vista LLC, 660 Coronado Drive, Sierra Vista, AZ 85635 | 2020-05-06 |
| 1568001543 | Gp Medicine, Pllc | Family Medicine | 1800 E Wilcox Drive, Sierra Vista, AZ 85635 | 2019-12-23 |
| 1518515212 | Canyon Vista Dental | Dentist | 1993 S Frontage Road, Suite 208, Sierra Vista, AZ 85635 | 2019-08-27 |
| 1225697402 | Kristine Vincent Cruz Angeles | Dentist | 115 Calle Poral, Sierra Vista, AZ 85635 | 2019-06-11 |
| 1700397411 | Vivian Ryu | Social Worker | 2300 E Fry Blvd, #3822, Sierra Vista, AZ 85635 | 2017-10-20 |
| 1750806758 | Rosemary Nduta Kagwanja | Technician | 425 Bernini Avenue, N/a, Sierra Vista, AZ 85635 | 2017-08-10 |
| 1093245789 | Akdhc, LLC | Internal Medicine | 5555 Mesa Verde Dr, Suite 100, Sierra Vista, AZ 85635 | 2017-06-14 |
| 1609304633 | Vincent Guarino | Emergency Medicine | 5700 E, Az-90, Sierra Vista, AZ 85635 | 2017-06-04 |
| 1629506811 | Andrew Tang | Student in an Organized Health Care Education/Training Program | 5700 Arizona 90, Sierra Vista, AZ 85635 | 2017-06-01 |
| 1194259382 | Walik Hargett | Contractor | 800 N. Lenzner Ave Apt 776b, Sierra Vista, AZ 85635 | 2017-04-14 |
| Find all providers in zip 85635 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609304633 | Vincent Guarino | Emergency Medicine | 5700 E, Az-90, Sierra Vista, AZ 85635 | 2017-06-04 |
| 1124077086 | Sierra Vista Emergency Physicians | Emergency Medicine | 5700 E Highway 90, Sierra Vista, AZ 85635-9110 | 2006-05-09 |
| 1598280893 | Fedko Emergency Physicians LLC | Emergency Medicine | 5700 E Highway 90, Sierra Vista, AZ 85635-9110 | 2017-08-08 |
| 1124448683 | Michael Mclaughlin | Emergency Medicine | 5700 E Highway 90, Sierra Vista, AZ 85635-9110 | 2014-04-23 |
| 1659456333 | Robert Lane Tassin | Emergency Medicine | 300 El Camino Real, Sierra Vista, AZ 85635-2812 | 2006-10-25 |
| 1881783322 | Scott J Megna | Emergency Medicine | 300 El Camino Real, Sierra Vista, AZ 85635-2812 | 2006-10-12 |
| 1629163068 | John K Barberii | Emergency Medicine | 302 El Camino Real, Suite 11cd, Sierra Vista, AZ 85635-1830 | 2006-10-03 |
| 1124042056 | Warren A Gluck | Emergency Medicine | 300 El Camino Real, Sierra Vista, AZ 85635-2812 | 2006-07-26 |
| 1457375388 | Everett R Castle Jr. | Emergency Medicine | 300 El Camino Real, Sierra Vista, AZ 85635-2812 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627815 | Fep Ncch | Emergency Medicine | 8825 N 23rd Ave Ste 100, Phoenix, AZ 85021-4148 | 2020-10-22 |
| 1780202804 | Cep America- Arizona, PC | Emergency Medicine | 1405 S. Alma School Rd., Chandler, AZ 85286 | 2020-07-07 |
| 1932755006 | Ucc Tucson Holdings, LLC. | Emergency Medicine | 18773 S Nogales Hwy Ste 125, Green Valley, AZ 85614-0403 | 2019-08-14 |
| 1831652189 | Derek Allan Hatfield | Emergency Medicine | 1625 N Campbell Ave., Tucson, AZ 85719 | 2019-04-12 |
| 1053874305 | Travis Patrick Martin | Emergency Medicine | 1625 N. Campbell Ave, Tucson, AZ 85719 | 2019-04-12 |
| 1245793504 | Martin Cisneroz | Emergency Medicine | 1625 North Campbell Avenue, Tucson, AZ 85719 | 2019-04-12 |
| 1174086722 | Sarah Joy Ring | Emergency Medicine | 1625 N. Campbell Ave., Tucson, AZ 85719 | 2019-04-10 |
| 1386106391 | Joshua Lee Price | Emergency Medicine | 708 S Coeur D Alene Ln Ste A, Payson, AZ 85541-5662 | 2019-04-01 |
| 1346708708 | Colonna Physician Services LLC | Emergency Medicine | 4030 N Stockton Hill Rd Ste 3, Kingman, AZ 86409-2452 | 2019-03-05 |
| 1487181491 | Alexander Joseph Tomesch | Emergency Medicine | 655 N Alvernon Way Ste 228, Tucson, AZ 85711-1853 | 2017-05-22 |
| Find all providers with the same taxonomy | ||||
| City | SIERRA VISTA |
| Zip Code | 85635 |
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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.