KOKOPELLI EYE CARE PC (NPI# 1114140019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114140019 |
| Entity Type | Organization |
| Organization Name | KOKOPELLI EYE CARE PC |
| Practice Address |
412 Whipple St Prescott AZ 86301-1712 |
| Mailing Address |
2820 N Glassford Hill Rd Suite 101 Prescott Valley AZ 86314-1242 |
| Practice Telephone | 9287719000 |
| Practice Fax Number | 9287719460 |
| Mailing Telephone | 9287755606 |
| Mailing Fax Number | 9287724999 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-11-16 |
| Authorized Official Name | MR. MICHAEL L HAM (PRESIDENT) |
| Authorized Official Telephone | 9287719000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | KOKOPELLI EYE CARE, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
OSC3634 | AZ | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023663010 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 9151 W Thunderbird Rd Ste 104, Peoria, AZ 85381-4906 | 2019-08-06 |
| 1619470085 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 5140 W Peoria Ave Ste 116, Glendale, AZ 85302-1631 | 2018-03-13 |
| 1669975157 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 16605 E Palisades Blvd Ste 152, Fountain Hills, AZ 85268-3717 | 2018-03-12 |
| 1184175416 | Kokopelli Eye Care PC | Eyewear Supplier (Equipment, not the service) | 15033 W Bell Rd Ste 150, Surprise, AZ 85374-3262 | 2016-10-21 |
| 1396294583 | Kokopelli Eye Care PC | Eyewear Supplier (Equipment, not the service) | 2403 N Stockton Hill Rd, Suite 1, Kingman, AZ 86401-4188 | 2016-09-28 |
| 1174026546 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 25 W Yavapai St, Wickenburg, AZ 85390-3280 | 2018-03-13 |
| 1750894655 | Kokopelli Eye Care PC | Eyewear Supplier (Equipment, not the service) | 2820 N Glassford Hill Rd, Prescott Valley, AZ 86314-1242 | 2017-11-14 |
| 1841457819 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 412 Whipple St, Prescott, AZ 86301-1712 | 2008-05-19 |
| 1528005444 | Kokopelli Eye Care PC | Specialist | 2820 N Glassford Hill Rd, Suite 101, Prescott Valley, AZ 86314-1242 | 2006-05-31 |
| Street Address |
412 WHIPPLE ST |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86301-1712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891320453 | Ophthalmic Consultants of Arizona, LLC | Clinic/Center | 412 Whipple St, Prescott, AZ 86301-1712 | 2020-03-04 |
| 1114239969 | Tkc Holdings LLC | Taxi | 412 Whipple St, Prescott, AZ 86301-1712 | 2010-07-09 |
| 1841457819 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 412 Whipple St, Prescott, AZ 86301-1712 | 2008-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102350 | Dove Marie Gundermann | Specialist/Technologist | 300 W. Gurley St, Prescott, AZ 86301 | 2020-07-30 |
| 1639712110 | Arizona Orthopedic Physical Therapy, Pllc | Clinic/Center | 1781 E State Highway 69, Suite 28, Prescott, AZ 86301 | 2019-10-28 |
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1336612571 | Sarah Elizabeth Elliott | Registered Nurse | 500 Az 89, Prescott, AZ 86301 | 2019-01-10 |
| 1912484270 | Asya Ruth Perkins | Counselor | 225 Grove Avenue, Prescott, AZ 86301 | 2018-07-19 |
| 1396241394 | Jerome Alexander Longoria | Chiropractor | 142 N. Rush St, Prescott, AZ 86301 | 2018-03-30 |
| 1619487675 | Yavapai Healthcare Group LLC | Nurse Practitioner | 999 Division Street, Prescott, AZ 86301 | 2017-10-04 |
| 1053835843 | United States Veterans Initiative | Counselor | 917 E Gurley St, Prescott, AZ 86301 | 2017-08-02 |
| 1164896999 | Spitler - Lilley, LLC | Hearing Instrument Specialist | 1781 E. State Rte 69, Suite 65, Prescott, AZ 86301 | 2015-11-17 |
| 1275925265 | Oral and Facial Surgery Center of Prescott | Dentist | 5415 Distiction Way, Prescott, AZ 86301 | 2015-02-27 |
| Find all providers in zip 86301 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083624670 | Prescott Outpatient Surgical Center | Clinic/Center | 815 Ainsworth Dr, Prescott, AZ 86301-1631 | 2006-08-08 |
| 1326089715 | Southwestern Eye Center Ltd | Clinic/Center | 1600 Willow Creek Rd, Prescott, AZ 86301-1108 | 2006-06-09 |
| 1437101433 | Tri City Surgery Center LLC | Clinic/Center | 5430 Distinction Way, Prescott, AZ 86301-4454 | 2006-05-17 |
| 1891320453 | Ophthalmic Consultants of Arizona, LLC | Clinic/Center | 412 Whipple St, Prescott, AZ 86301-1712 | 2020-03-04 |
| 1548593916 | Wm. Wade Collison Md | Clinic/Center | 1050 Gail Gardner Way, Suite 200, Prescott, AZ 86305-1630 | 2009-09-16 |
| 1720278047 | Arizona Institute of Eye Surgery, LLC | Clinic/Center | 3192 Willow Creek Rd, 3192 Willow Creek Road, Prescott, AZ 86301-6610 | 2007-08-01 |
| 1447458591 | Advanced Plastic Surgery Center, L.L.C. | Clinic/Center | 1615 Petroglyph Point Dr, Prescott, AZ 86301-6539 | 2007-07-10 |
| 1306877758 | Barnet Dulaney Surgery Centers, Pllc | Clinic/Center | 1680 Willow Creek Rd, Prescott, AZ 86301-1108 | 2006-07-05 |
| 1790711091 | Prescott Urocenter Ltd | Clinic/Center | 811 Ainsworth Dr, Suite 101, Prescott, AZ 86301-1687 | 2006-06-25 |
| 1336107036 | Rummel Eye Care, P.C. | Clinic/Center | 1022 Willow Creek Rd, Prescott, AZ 86301-1607 | 2006-05-02 |
| Find all providers in PRESCOTT | ||||
Please comment or provide details below to improve the information on KOKOPELLI EYE CARE PC.
| 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.