PRESCOTT CLINIC P.C. (NPI# 1295248508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295248508 |
| Entity Type | Organization |
| Organization Name | PRESCOTT CLINIC P.C. |
| Practice Address |
125 N Washington St Prescott MI 48756-5117 |
| Mailing Address |
1003 Woodside Ave Essexville MI 48732-1234 |
| Practice Telephone | 9898733352 |
| Practice Fax Number | 9898733949 |
| Mailing Telephone | 9898927722 |
| Mailing Fax Number | 9898927455 |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |
| Authorized Official Name | WILLIAM E BERNER (ADMINISTRATOR) |
| Authorized Official Telephone | 9898927722 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881622835 | Prescott Clinic P.C. | Family Medicine | 125 Washington, Prescott, MI 48756 | 2006-06-29 |
| Street Address |
125 N WASHINGTON ST |
| City | PRESCOTT |
| State | MI |
| Zip Code | 48756-5117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568005569 | Jennifer Lynn Datzko | Nurse Practitioner | 125 N Washington St, Prescott, MI 48756-5117 | 2019-10-22 |
| 1992831960 | Charles E Jessup | Family Medicine | 125 N Washington St, Prescott, MI 48756-5117 | 2007-02-26 |
| 1578626735 | Richard Steven Gaft | Emergency Medicine | 125 N Washington St, Box 114, Prescott, MI 48756-5117 | 2006-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932571056 | Gabriel Wayne Wallace | Technician | 5208 Michiban Ave., Prescott, MI 48756 | 2015-10-28 |
| 1881622835 | Prescott Clinic P.C. | Family Medicine | 125 Washington, Prescott, MI 48756 | 2006-06-29 |
| 1407194954 | Jimmie S Ward Sr. | Physician Assistant | 125 Washington Ave, Prescott, MI 48756-5117 | 2013-01-17 |
| 1659379915 | Antonio F Mendiola Jr. | General Practice | 1827 Greenwood Rd, Prescott, MI 48756-8626 | 2005-07-12 |
| 1881679645 | Sterling Area Health Center | Clinic/Center | 1827 Greenwood Rd, Prescott, MI 48756-8626 | 2005-12-14 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1750319083 | Daniel Edward Greene | Chiropractor | 1818 Greenwood Rd, Prescott, MI 48756-8627 | 2006-06-28 |
| 1619477338 | Corinne Crawford | Behavior Technician | 3909 Rifle River Trl, Prescott, MI 48756-9345 | 2018-02-19 |
| 1598258329 | Aliyah Marie Allen | Behavior Technician | 5130 Greenwood Rd, Prescott, MI 48756-9616 | 2018-06-06 |
| 1558405217 | Roos Pharmacy North, Inc. | Pharmacy | 2370 Greenwood Rd, Prescott, MI 48756-9655 | 2007-02-16 |
| Find all providers in zip 48756 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538714092 | Prescott Complete Care | Family Medicine | 1947 Commerce Center Circle, Suite A, Prescott, AZ 86301 | 2019-08-01 |
| 1205309812 | Priority Family Medical Clinic LLC | Family Medicine | 3625 Crossings Dr Ste B, Prescott, AZ 86305-7159 | 2019-01-07 |
| 1740462779 | Lawrence H Borish | Family Medicine | 4100 W Marlow Rd, Prescott, AZ 86305-5511 | 2007-11-30 |
| 1295940351 | Kevin S Doyle Md Pllc | Family Medicine | 905 Angelita Dr, Prescott, AZ 86303-5019 | 2007-05-11 |
| 1811029804 | Keith Marion Keating | Family Medicine | 3607 Crossings Dr Ste B, Prescott, AZ 86305-7149 | 2007-03-12 |
| 1124156997 | Irene Anna Royko | Family Medicine | 1654 Coyote Rd, Prescott, AZ 86303-5339 | 2007-03-01 |
| 1144398355 | Mark Everett Kiffer | Family Medicine | 6200 W Indian Pony Ct, Prescott, AZ 86305-1542 | 2006-12-04 |
| 1023181583 | Robert Jeffrey Zieve | Family Medicine | 343 S Montezuma St, Prescott, AZ 86303-7022 | 2006-11-15 |
| 1154413789 | Kenneth Purdy Archer | Family Medicine | 1003 Division Street, Suite # 3, Prescott, AZ 86301-1657 | 2006-09-29 |
| 1730289380 | Ellen F. Bunch | Family Medicine | 1530 W Cliff Rose Rd, Prescott, AZ 86305-7434 | 2006-09-24 |
| Find all providers in PRESCOTT | ||||
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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.