MOUNTAIN HEART MEDICAL PRACTICE PLLC


Address: 2000 S Thompson St, Flagstaff, AZ 86001-8759
Phone: 9282266400

MOUNTAIN HEART MEDICAL PRACTICE PLLC (NPI# 1306009519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306009519
Entity Type Organization
Organization Name MOUNTAIN HEART MEDICAL PRACTICE PLLC
Practice Address 2000 S Thompson St
Flagstaff
AZ 86001-8759
Practice Telephone 9282266400
Practice Fax Number 9282266411
Mailing Telephone 9282266400
Mailing Fax Number 9282266411
Enumeration Date 2008-07-08
Last Update Date 2009-04-07
Authorized Official Name MRS. SUZANNE R DUVAL (CREDENTIALING)
Authorized Official Telephone 90282266400
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0000X Internal Medicine
Specialization: Cardiovascular Disease
30420 AZ Allopathic & Osteopathic Physicians

Office Location

Street Address 2000 S THOMPSON ST
City FLAGSTAFF
State AZ
Zip Code 86001-8759

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174526677 Renzo M Cataldo Specialist 2000 S Thompson St, Flagstaff, AZ 86001 2005-05-27
1295341089 Karen Vanaman Nurse Practitioner 2000 S Thompson St, Flagstaff, AZ 86001-8759 2020-09-17
1548781438 Scott Lawrence Krankkala Physician Assistant 2000 S Thompson St, Flagstaff, AZ 86001 2017-06-29
1356709877 Erin Rasmussen Nurse Practitioner 2000 S Thompson St, Flagstaff, AZ 86001 2016-01-29
1770958639 Sherry O'brien Registered Nurse 2000 S Thompson St, Flagstaff, AZ 86001-8759 2015-12-03
1114397957 Amy Kathryn Taylor Nurse Practitioner 2000 S Thompson St, Flagstaff, AZ 86001 2015-10-06
1194113399 Elisa Hilburn Nurse Practitioner 2000 S Thompson St, Flagstaff, AZ 86001 2014-12-23
1013305283 Bruce A Mortensen Physician Assistant 2000 S Thompson St, Flagstaff, AZ 86001-8759 2014-12-22
1770846842 Martha Barlow Nurse Practitioner 2000 S Thompson St, Flagstaff, AZ 86001 2012-06-22
1568739605 Dhhs Ihs Phoenix Area Clinic/Center 2000 S Thompson St, Flagstaff, AZ 86001-8759 2011-11-17
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207RC0000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Cardiovascular Disease

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629220009 Flagstaff Medical Center Internal Medicine 1215 N Beaver St Ste 203, Flagstaff, AZ 86001-3126 2008-10-16
1447334784 Robert A Mackin Internal Medicine 823 North Beaver Street, Flagstaff, AZ 86001 2006-10-24
1447295324 Mohan Reddi Nandalur Internal Medicine 1215 N Beaver Street, Heart & Vascular Center of Northern Arizona, Flagstaff, AZ 86001-3118 2006-06-17
1851396105 John Howley Internal Medicine 1330 N Rim Dr, Ste B, Flagstaff, AZ 86001-3138 2005-06-14
1992064927 Northern Arizona Healthcare Provider Group, LLC Internal Medicine 1215 N Beaver St, Flagstaff, AZ 86001-3126 2012-05-11
1982871067 Flagstaff Medical Center Internal Medicine 1200 N Beaver St, Flagstaff, AZ 86001-3118 2008-05-08
1730372343 John W. Howley, Md PC Internal Medicine 1330 N Rim Dr, Ste B, Flagstaff, AZ 86001-3134 2007-08-27
1326265893 Omar Rashid Wani Internal Medicine 2000 S Thompson St, Flagstaff, AZ 86001 2007-04-19
1023167384 Craig Michael Peters Internal Medicine 1215 N Beaver St, Heart & Vascular Center of Northern Arizona, Flagstaff, AZ 86001-3118 2007-01-09
1639242720 David M Leder Internal Medicine 2000 S Thompson St, Flagstaff, AZ 86001 2006-11-16
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City FLAGSTAFF
Zip Code 86001

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Dataset Information

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.

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