ELYSIA SMALL (NPI# 1174074991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174074991 |
| Entity Type | Individual |
| Full Name | ELYSIA SMALL |
| Credential | PA |
| Practice Address |
1501 S Yale St Building 2 Suite 150 Flagstaff AZ 86001-7304 |
| Mailing Address |
710 N Beaver St Flagstaff AZ 86001-3100 |
| Practice Telephone | 9285274325 |
| Practice Fax Number | 9285274327 |
| Mailing Telephone | 9285274325 |
| Mailing Fax Number | 9285274327 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
6563 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1501 S YALE ST BUILDING 2 SUITE 150 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-7304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003811068 | Christine Crowder | General Practice | 1501 S Yale St, Bldg 2 Suite 150, Flagstaff, AZ 86001-7304 | 2005-06-16 |
| 1669911764 | North Country Healthcare, Inc. | Pediatrics | 1501 S Yale St, Ste 252, Flagstaff, AZ 86001-7304 | 2017-02-22 |
| 1578910295 | Munderloh Medical LLC | Chiropractor | 1501 S Yale St, 250, Flagstaff, AZ 86001-7304 | 2016-05-23 |
| 1518309350 | Jeremy K Burdick | Nurse Practitioner | 1501 S Yale St, 252, Flagstaff, AZ 86001-7304 | 2013-07-22 |
| 1326393927 | Proforma Health Pllc | Chiropractor | 1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7304 | 2012-07-19 |
| 1235371493 | Travis Clark Stiegler | Psychiatry & Neurology | 1501 S Yale St, Ste 250, Flagstaff, AZ 86001-7304 | 2009-04-01 |
| 1891825022 | Michelle Doroz | Family Medicine | 1501 S Yale St, Bldg 2 Suite 150, Flagstaff, AZ 86001-7304 | 2007-03-06 |
| 1417082553 | Theresa Dowell | Physical Therapist | 1501 S Yale St, Ste# 252, Flagstaff, AZ 86001-7304 | 2007-02-22 |
| 1447397336 | Retail Automation Usa LLC | Chiropractor | 1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7304 | 2007-01-31 |
| 1285703918 | Flagstaff Primary Care, PC | Pediatrics | 1501 S Yale St, Ste #252, Flagstaff, AZ 86001-7304 | 2006-11-07 |
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| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225541584 | Rachelle Dana Eddie | Physician Assistant | 12880 Three Man Trl, Flagstaff, AZ 86004-3004 | 2017-11-08 |
| 1265943252 | Gavin Ferguson | Physician Assistant | 1515 E Cedar Ave Ste 2b3b4e12, Flagstaff, AZ 86004-1600 | 2017-10-17 |
| 1124338504 | Timothy Lawrence Jackson | Physician Assistant | 2722 N Mariah Way, Flagstaff, AZ 86004-7550 | 2010-10-19 |
| 1164488953 | Barbara Elias | Physician Assistant | 4545 E Wild Elk Trl, Flagstaff, AZ 86004-7941 | 2006-04-21 |
| 1811538507 | Jody Brooke Herron | Physician Assistant | 3150 N Winding Brook Rd, Flagstaff, AZ 86001-0972 | 2019-10-03 |
| 1881143386 | Arianne C Hyder | Physician Assistant | 77 W Forest Ave Ste 201, Flagstaff, AZ 86001-1483 | 2016-09-25 |
| 1457610438 | Chad William Norris | Physician Assistant | 1485 N Turquoise Dr, Flagstaff, AZ 86001-1398 | 2012-05-10 |
| 1376600171 | Karen Kathryn Damgaard | Physician Assistant | 2920 N 4th St, Flagstaff, AZ 86004-1816 | 2007-01-02 |
| 1356314025 | Nitza L Glick | Physician Assistant | 107 E Oak Ave, Suite 202, Flagstaff, AZ 86001-1818 | 2006-02-10 |
| 1578535464 | David Scott Brown | Physician Assistant | 77 W Forest Ave, Suite 301, Flagstaff, AZ 86001-1479 | 2006-02-03 |
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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.