DR. KENNETH JOHN BESCAK (NPI# 1164401592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164401592 |
| Entity Type | Individual |
| Full Name | DR. KENNETH JOHN BESCAK |
| Credential | MD |
| Practice Address |
294 W State Route 89a Suite 107 Cottonwood AZ 86326-3754 |
| Mailing Address |
1200 N Beaver St Payer Credentialing Flagstaff AZ 86001-3118 |
| Practice Telephone | 9286341331 |
| Practice Fax Number | 9286343130 |
| Mailing Telephone | 9282136235 |
| Mailing Fax Number | 9282136292 |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2016-11-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
40903 | AZ | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35036051 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0413832 | 05 | |
| OH | SUMMA | E36051 | 01 |
| RAILROAD MEDICARE # | 060013315 | 01 | |
| OH | CARESOURCE | 341221800045 | 01 |
| AZ | 413507 | 05 | |
| OH | KAISER | 100402 | 01 |
| OH | ANTHEM | 000000128703 | 01 |
| Street Address |
294 W STATE ROUTE 89A SUITE 107 |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326-3754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568459717 | John S. Schor | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 294 W State Route 89a, Suite 107, Cottonwood, AZ 86326-3754 | 2005-10-03 |
| 1730637109 | Donna Clark | Social Worker | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2016-09-14 |
| 1265846968 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2014-06-20 |
| 1508299728 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2013-08-12 |
| 1417292582 | Northern Arizona Healthcare Provider Group, LLC | Urology | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2012-11-30 |
| 1669730610 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2012-04-27 |
| 1700154051 | Fran Willetts | Nurse Practitioner | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2011-12-01 |
| 1508190174 | Stephanie Marie Purinton | Advanced Practice Midwife | 294 W State Route 89a, Suite 209, Cottonwood, AZ 86326-3754 | 2009-09-29 |
| 1295985240 | Scott A Cherne Md PC | Durable Medical Equipment & Medical Supplies | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2008-09-26 |
| 1801069158 | Black Hills Urology Group, P.C. | Urology | 294 W State Route 89a, Suite 208, Cottonwood, AZ 86326-3754 | 2008-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679954895 | Isabelle Maisse Griffith | Pharmacist | 1100 E Highway 89a, Cottonwood, AZ 86326 | 2015-06-12 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1922391663 | Ronald D. Carsrud | Hearing Instrument Specialist | 657 E Cottonwood St., Ste 6c, Cottonwood, AZ 86326 | 2011-05-26 |
| 1760712749 | Chuck Thomas Calvano | Pharmacist | 550 S Main, Cottonwood, AZ 86326 | 2010-01-13 |
| 1528231438 | Elizabeth Lightner Mccarrell | Emergency Medicine | 269 S Candy Lane, Cottonwood, AZ 86326 | 2008-04-11 |
| 1972783355 | The Wick Home for Emotional Growth and Recovery | Residential Treatment Facility, Emotionally Disturbed Children | 2102 E Fir St, Cottonwood, AZ 86326 | 2007-11-14 |
| 1750560165 | David T Sayle | Nurse Practitioner | 800 Cove Parkway, Cottonwood, AZ 86326 | 2007-11-01 |
| 1003001033 | Country Care Inc | Assisted Living Facility | 3980 E Cassie Lane, Cottonwood, AZ 86326 | 2007-09-12 |
| 1154527778 | Laurel A Mueller | Family Medicine | 51 Brian Mickelsen Pkwy, Community Health Center of Yavapai, Cottonwood, AZ 86326 | 2007-06-21 |
| 1841401700 | Bruce Alan Moseng | Chiropractor | 240 Jennifer Lane, Ste 103, Cottonwood, AZ 86326 | 2007-05-24 |
| Find all providers in zip 86326 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1700889425 | Steve M Heilbrunn | Internal Medicine | 294 State Route 89a, Suite 107, Cottonwood, AZ 86326-3763 | 2005-05-27 |
| 1669730610 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2012-04-27 |
| 1457665945 | Providence Health & Services | Internal Medicine | 701 Lewiston Street, Cottonwood, ID 83522-0000 | 2010-07-27 |
| 1942432620 | Arizona Heart Specialists Pllc | Internal Medicine | 450 S Willard St, Ste 115, Cottonwood, AZ 86326-6743 | 2009-08-14 |
| 1699942771 | Verde Valley Medical Center | Internal Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2008-05-08 |
| 1992980452 | Verde Valley Medical Center-professional | Internal Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2008-01-03 |
| 1598849721 | Verde Valley Heart, LLC | Internal Medicine | 294 W Highway 89a, Suite 107, Cottonwood, AZ 86326-3754 | 2006-10-24 |
| 1689776908 | Bruce William Peek | Internal Medicine | 294 State Route 89a, Suite 107, Cottonwood, AZ 86326-3763 | 2006-09-05 |
| 1205943008 | Daniel V Lindenstruth | Internal Medicine | 294 W State Route 89a, Suite 107, Cottonwood, AZ 86326-3754 | 2006-08-25 |
| 1982616884 | Samuel M Butman | Internal Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2006-08-12 |
| Find all providers in COTTONWOOD | ||||
| City | COTTONWOOD |
| Zip Code | 86326 |
Please comment or provide details below to improve the information on DR. KENNETH JOHN BESCAK.
| 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.