LAVERNE KING (NPI# 1255578043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255578043 |
| Entity Type | Individual |
| Full Name | LAVERNE KING |
| Credential | R.T. (R)(M) |
| Practice Address |
167 N. Main St. Tuba City AZ 86045 |
| Mailing Address |
Po Box 600 Tuba City AZ 86045-0600 |
| Practice Telephone | 9282832198 |
| Practice Fax Number | 9282831312 |
| Mailing Telephone | 9282832198 |
| Mailing Fax Number | 9282831312 |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-01-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 247100000X | Radiologic Technologist | 14515 | AZ | Technologists, Technicians & Other Technical Service Providers |
| Y | 2471M2300X |
Radiologic Technologist Specialization: Mammography |
2777 | AZ | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
167 N. MAIN ST. |
| City | TUBA CITY |
| State | AZ |
| Zip Code | 86045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780800441 | Amy E Suhr | Dentist | 167 N. Main St., Tuba City Regional Health Care, Dental Department, Tuba City, AZ 86045 | 2007-04-18 |
| 1245507730 | Darrell Glen Castleberry | Registered Nurse | 167 N. Main St., Tuba City, AZ 86045 | 2011-11-28 |
| 1457638561 | Louis Irvin Phillips | Radiologic Technologist | 167 N. Main St., Tuba City, AZ 86045-0600 | 2011-11-03 |
| 1699066977 | Brandon Owen Thomas | Respiratory Therapist, Registered | 167 N. Main St., Tuba City, AZ 86045-0600 | 2011-04-21 |
| 1053602433 | Angela L. Kiyaani | Technician/Technologist | 167 N. Main St., Tuba City, AZ 86045-0600 | 2011-04-20 |
| 1386934255 | Linette Howard | Nurse's Aide | 167 N. Main St., Tuba City, AZ 86045 | 2011-04-13 |
| 1528363322 | Stacy Mackelprang | Registered Nurse | 167 N. Main St., Tuba City, AZ 86045-0600 | 2011-01-26 |
| 1437451366 | Erin Nocki | Nurse's Aide | 167 N. Main St., Tuba City, AZ 86045-0600 | 2010-11-29 |
| 1285935635 | Darlene Yellowhair | Nurse's Aide | 167 N. Main St., Tuba City, AZ 86045 | 2010-11-16 |
| 1922309590 | Latoya Rae Nez | Nurse's Aide | 167 N. Main St., Tuba City, AZ 86045 | 2010-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434206 | Ambrielle Grace Begay | Specialist/Technologist | 48 Turquoise Drive, Tuba City, AZ 86045 | 2020-10-12 |
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1609422484 | Rebekah Lee | Pharmacist | 167 North Main St. Tuba City Regional Health Care Corp., Tuba City, AZ 86045 | 2019-08-16 |
| 1861977050 | Kyle C Nguyen | Pharmacist | 3008 E. Birch Ave, Tuba City, AZ 86045 | 2018-10-03 |
| 1518419845 | John Glenn Ives | Pharmacist | 167 N, Main St, Tuba City, AZ 86045 | 2016-11-03 |
| 1497208433 | Toweringrock Non-emergency Medical Transport, LLC | Non-emergency Medical Transport (VAN) | 1029 E. Tc North Side Trailer, 36.153821-111.233925, Tuba City, AZ 86045 | 2016-07-26 |
| 1699153270 | Hopi Assisted Living Facility Inc. | Point of Service | 21 Senior Lane Upper Hud Housing Moenkopi, Hopi Assisted Living, Tuba City, AZ 86045 | 2015-05-14 |
| 1306223870 | Mia Seimy | Driver | Adair Avenue Space #5, Tuba City, AZ 86045 | 2015-05-04 |
| 1033507587 | Tari Carroll | Home Health Aide | Tumbleweed Drive Nha E-3, Tuba City, AZ 86045 | 2015-01-07 |
| 1023452984 | Amanda Bancroft Burrage | Pediatrics | 167 Main St., Tuba City, AZ 86045 | 2013-04-23 |
| Find all providers in zip 86045 | ||||
| Taxonomy Code | 2471M2300X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Mammography |
| Definition to come... |
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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.