NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC (NPI# 1104260421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104260421 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC |
| Other Organization Name | TEAM HEALTH NEUROPSYCHOLOGY |
| Practice Address |
107 E Oak Ave Flagstaff AZ 86001-1818 |
| Mailing Address |
1200 N Beaver St Attn: Managed Care Contracting Flagstaff AZ 86001-3118 |
| Practice Telephone | 9289138800 |
| Mailing Telephone | 9282136543 |
| Mailing Fax Number | 9282143613 |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2019-04-16 |
| Authorized Official Name | RONALD F HAASE (NAH CHIEF SYSTEMS OFFICER) |
| Authorized Official Telephone | 9287732059 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHERN ARIZONA HEALTHCARE CORP. |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Team Health Neuropsychology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417384371 | Northern Arizona Healthcare Provider Group, LLC | Optometrist | 1298 W Finnie Flat Rd # 101, Camp Verde, AZ 86322-5958 | 2013-10-08 |
| 1851659817 | Northern Arizona Healthcare Provider Group, LLC | Surgery | 199 South Candy Lane, Cottonwood, AZ 86326-4183 | 2012-04-27 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1386099869 | Northern Arizona Healthcare Provider Group, LLC | Anesthesiology | 1200 N. Beaver Street, Attn: Payer Credentialing, Flagstaff, AZ 86001-3118 | 2016-05-03 |
| 1295121903 | Northern Arizona Healthcare Provider Group, LLC | Obstetrics & Gynecology | 269 South Candy Lane, Flagstaff, AZ 86326 | 2015-04-09 |
| 1174914915 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2015-02-16 |
| 1699182188 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2014-07-16 |
| 1265846968 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2014-06-20 |
| 1740694470 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-06-20 |
| 1003230830 | Northern Arizona Healthcare Provider Group, LLC | Psychologist | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-02-14 |
| Street Address |
107 E OAK AVE |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316931702 | Jon R Shereck | Orthopaedic Surgery | 107 E Oak Ave, Flagstaff, AZ 86001 | 2005-08-31 |
| 1013546340 | Zachary Scott Hinger | Orthopaedic Surgery | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2020-04-08 |
| 1548746928 | Sarah Wyard | Nurse Practitioner | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2018-07-18 |
| 1255799789 | Iris Maczura | Nurse Practitioner | 107 E Oak Ave, Suite 201, Flagstaff, AZ 86001-1818 | 2016-01-28 |
| 1568870988 | Megan Marie Alatorre | Physician Assistant | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-07-29 |
| 1740694470 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-06-20 |
| 1003230830 | Northern Arizona Healthcare Provider Group, LLC | Psychologist | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-02-14 |
| 1801133566 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2013-01-14 |
| 1508119348 | Northern Arizona Healthcare Provider Group, LLC | Psychiatry & Neurology | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2012-10-17 |
| 1689923096 | Justin Michael Delange | Psychiatry & Neurology | 107 E Oak Ave, Suite 101, Flagstaff, AZ 86001-1818 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154595338 | John Alden Zarske | Clinical Neuropsychologist | 119 E Terrace Ave Ste C, Flagstaff, AZ 86001-5267 | 2008-04-17 |
| 1295925386 | Della S Lusk | Clinical Neuropsychologist | 710 N. Beaver Street, Bldg 4, Flagstaff, AZ 86001-3139 | 2007-07-26 |
| 1558336818 | Arizona Behavioral Health Associates, P.C. | Clinical Neuropsychologist | 710 N Beaver St, Bldg 4, Flagstaff, AZ 86001-3139 | 2006-02-21 |
| 1992841225 | Northern Arizona Neuropsychology PC | Clinical Neuropsychologist | 616 N Beaver St, Flagstaff, AZ 86001-3012 | 2007-01-30 |
| 1841396140 | Frances M Robbins | Clinical Neuropsychologist | 416 N Kendrick St, Ste. 5, Flagstaff, AZ 86001-1598 | 2006-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467088062 | Generational Bridges Neuropsychological Services Pllc | Clinical Neuropsychologist | 1515 E Missouri Dr, Phoenix, AZ 85014 | 2020-03-16 |
| 1750862264 | Focus Neuropsychology Az, Pllc | Clinical Neuropsychologist | 2400 N Central Ave Ste 204, Phoenix, AZ 85004-1341 | 2018-08-22 |
| 1386172732 | Brett Andersen | Clinical Neuropsychologist | 300 W Clarendon Ave Ste 130, Phoenix, AZ 85013-3421 | 2017-05-30 |
| 1164973467 | Neuropsychology Associates, PC | Clinical Neuropsychologist | 1515 E Missouri Ave Ste 110, Phoenix, AZ 85014-2443 | 2016-10-21 |
| 1134578677 | Renee Gutman | Clinical Neuropsychologist | 5715 N Calle De Lucimiento, Tucson, AZ 85718-5134 | 2016-06-06 |
| 1548618887 | Christina Marie Figueroa | Clinical Neuropsychologist | 10474 W Thunderbird Blvd Ste 201, Sun City, AZ 85351-3015 | 2016-05-26 |
| 1376908699 | Brain U, LLC | Clinical Neuropsychologist | 14200 N Northsight Blvd Ste 100, Scottsdale, AZ 85260 | 2015-12-31 |
| 1437524733 | Pinnacle Center, Inc. | Clinical Neuropsychologist | 4423 N 24th St, Phoenix, AZ 85016-5544 | 2015-12-11 |
| 1609249721 | Karen Haas Putnam | Clinical Neuropsychologist | 2209 E 4th St, Tucson, AZ 85719-5119 | 2015-11-11 |
| 1174927172 | Christopher Simpson | Clinical Neuropsychologist | 10184 W Happy Valley Rd, Suite 190, Peoria, AZ 85383-1254 | 2014-10-20 |
| 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.