CANYON MEDICAL CLINIC LLC (NPI# 1356834642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356834642 |
| Entity Type | Organization |
| Organization Name | CANYON MEDICAL CLINIC LLC |
| Practice Address |
34501 S Old Black Canyon Hwy # 1 Black Canyon City AZ 85324 |
| Mailing Address |
14534 W Hidden Terrace Loop Litchfield Park AZ 85340-0989 |
| Practice Telephone | 6233745070 |
| Practice Fax Number | 6233745068 |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2018-08-14 |
| Authorized Official Name | JOSHUA ERIC MOTL (PHYSICIAN ASSISTANT) |
| Authorized Official Telephone | 2183719340 |
| Authorized Official Credential | PA-C, MPAS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 912701 | 05 | |
| AZ | 1588081087 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 34501 S Old Black Canyon Hwy # 3, Black Canyon City, AZ 853249723 | 2183719340 |
| Street Address |
34501 S OLD BLACK CANYON HWY # 1 |
| City | BLACK CANYON CITY |
| State | AZ |
| Zip Code | 85324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356708655 | Home Health Services, Pllc | Clinic/Center | 19375 E. Oasis, Black Canyon City, AZ 85324 | 2016-01-19 |
| 1760669600 | Emd Medical Services LLC | Clinic/Center | 18850 E. Schoolhouse Road, Black Canyon City, AZ 85324 | 2008-01-22 |
| 1639380363 | Black Canyon City Dentistry LLC | Dentist | 34501 S Old Black Canyon City Highway, Suite 5, Black Canyon City, AZ 85324 | 2007-05-24 |
| 1477622405 | Kevin Carl Krause | Chiropractor | 34501 South Black Canyon Highway, Suite #3, Black Canyon City, AZ 85324 | 2006-11-06 |
| 1982669552 | Joshua Cheol-hong Kim | Internal Medicine | 34601 S. Phyllis St., Black Cayon City, AZ 85324 | 2006-04-18 |
| 1508079518 | Canon Elementary School District | Local Education Agency (LEA) | 34630 S School Loop Rd., Black Canyon City, AZ 85324-0089 | 2007-05-07 |
| 1265538474 | Marci Brown-gilpin | Counselor | 18850 E School House Rd, 3, Black Canyon City, AZ 85324-8787 | 2006-09-15 |
| 1669087599 | Heidi Marie Nida-huff | Nurse Practitioner | 19251 E Oasis Dr # 19251, Black Canyon City, AZ 85324-8878 | 2020-09-08 |
| 1467432971 | Randy Charles Hancock | Family Medicine | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2006-01-19 |
| 1033690169 | Preventative Dental Care Pllc | Clinic/Center | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2018-08-27 |
| Find all providers in zip 85324 | ||||
| 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 |
|---|---|---|---|---|
| 1467432971 | Randy Charles Hancock | Family Medicine | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2006-01-19 |
| 1679723217 | Black Canyon Community Health Center | Family Medicine | 19251 E Oasis Dr, Black Canyon City, AZ 85324-8878 | 2008-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446349 | Holding Hands Medical Pllc | Family Medicine | 8515 S College Ln, Tempe, AZ 85284-2342 | 2020-10-29 |
| 1730789876 | Kara Lindsay | Family Medicine | 10293 N 92nd St Ste 100, Scottsdale, AZ 85258-4565 | 2020-10-28 |
| 1184238164 | Mobile Np Pllc | Family Medicine | 5807 E Vernon Ave, Scottsdale, AZ 85257-1941 | 2020-09-07 |
| 1194339200 | Madison Le | Family Medicine | 3037 W Cat Balue Dr, Phoenix, AZ 85027-2342 | 2020-09-04 |
| 1649884065 | Miranda Gamgah Njante | Family Medicine | 10445 E Pivitol Ave, Mesa, AZ 85212-8037 | 2020-09-02 |
| 1447864830 | Prevencare Health Services, LLC | Family Medicine | 750 Bartow Dr Ste 16, Sierra Vista, AZ 85635-1833 | 2020-09-02 |
| 1093328767 | Whole Health Primary Care LLC | Family Medicine | 7113 W Sophie Ln, Laveen, AZ 85339-3475 | 2020-08-24 |
| 1942811997 | Raquiel Santos | Family Medicine | 4301 Plaza Vis Apt C, Sierra Vista, AZ 85635-4323 | 2020-08-13 |
| 1609493402 | Old Pueblo Mobile Medicine LLC | Family Medicine | 9721 E Colette St, Tucson, AZ 85748-2756 | 2020-06-29 |
| 1386261386 | Lillian Dolores Puma | Family Medicine | 6349 E Joan De Arc Ave, Scottsdale, AZ 85254-3834 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
| City | BLACK CANYON CITY |
| Zip Code | 85324 |
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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.