NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC (NPI# 1417292582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417292582 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC |
| Other Organization Name | VERDE VALLEY MEDICAL CLINIC: UROLOGY |
| Practice Address |
294 W State Route 89a Cottonwood AZ 86326-3754 |
| Mailing Address |
1200 North Beaver Street Attn: Managed Care Contracting Flagstaff AZ 86001-3118 |
| Practice Telephone | 9286497970 |
| Practice Fax Number | 9286497902 |
| Mailing Telephone | 9282136543 |
| Mailing Fax Number | 9282143613 |
| Enumeration Date | 2012-11-30 |
| Last Update Date | 2019-04-16 |
| Authorized Official Name | RONALD F HAASE (NAH CHIEF SYSTEMS OFFICER) |
| Authorized Official Telephone | 9287732059 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHERN ARIZONA HEALTHCARE CORP. |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Verde Valley Medical Clinic: Urology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417384371 | Northern Arizona Healthcare Provider Group, LLC | Optometrist | 1298 W Finnie Flat Rd # 101, Camp Verde, AZ 86322-5958 | 2013-10-08 |
| 1851659817 | Northern Arizona Healthcare Provider Group, LLC | Surgery | 199 South Candy Lane, Cottonwood, AZ 86326-4183 | 2012-04-27 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1386099869 | Northern Arizona Healthcare Provider Group, LLC | Anesthesiology | 1200 N. Beaver Street, Attn: Payer Credentialing, Flagstaff, AZ 86001-3118 | 2016-05-03 |
| 1295121903 | Northern Arizona Healthcare Provider Group, LLC | Obstetrics & Gynecology | 269 South Candy Lane, Flagstaff, AZ 86326 | 2015-04-09 |
| 1174914915 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2015-02-16 |
| 1699182188 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2014-07-16 |
| 1265846968 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2014-06-20 |
| 1740694470 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-06-20 |
| 1003230830 | Northern Arizona Healthcare Provider Group, LLC | Psychologist | 107 E Oak Ave, Flagstaff, AZ 86001-1818 | 2014-02-14 |
| Street Address |
294 W STATE ROUTE 89A |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326-3754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568459717 | John S. Schor | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 294 W State Route 89a, Suite 107, Cottonwood, AZ 86326-3754 | 2005-10-03 |
| 1730637109 | Donna Clark | Social Worker | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2016-09-14 |
| 1265846968 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2014-06-20 |
| 1508299728 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2013-08-12 |
| 1669730610 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2012-04-27 |
| 1700154051 | Fran Willetts | Nurse Practitioner | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2011-12-01 |
| 1508190174 | Stephanie Marie Purinton | Advanced Practice Midwife | 294 W State Route 89a, Suite 209, Cottonwood, AZ 86326-3754 | 2009-09-29 |
| 1295985240 | Scott A Cherne Md PC | Durable Medical Equipment & Medical Supplies | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2008-09-26 |
| 1801069158 | Black Hills Urology Group, P.C. | Urology | 294 W State Route 89a, Suite 208, Cottonwood, AZ 86326-3754 | 2008-04-08 |
| 1700086816 | Roberta Elaine Funck | Physician Assistant | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2007-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679954895 | Isabelle Maisse Griffith | Pharmacist | 1100 E Highway 89a, Cottonwood, AZ 86326 | 2015-06-12 |
| 1184982266 | Northern Arizona Healthcare Provider Group, LLC | Family Medicine | 450 South Willard Street, Cottonwood, AZ 86326 | 2012-04-26 |
| 1922391663 | Ronald D. Carsrud | Hearing Instrument Specialist | 657 E Cottonwood St., Ste 6c, Cottonwood, AZ 86326 | 2011-05-26 |
| 1760712749 | Chuck Thomas Calvano | Pharmacist | 550 S Main, Cottonwood, AZ 86326 | 2010-01-13 |
| 1528231438 | Elizabeth Lightner Mccarrell | Emergency Medicine | 269 S Candy Lane, Cottonwood, AZ 86326 | 2008-04-11 |
| 1972783355 | The Wick Home for Emotional Growth and Recovery | Residential Treatment Facility, Emotionally Disturbed Children | 2102 E Fir St, Cottonwood, AZ 86326 | 2007-11-14 |
| 1750560165 | David T Sayle | Nurse Practitioner | 800 Cove Parkway, Cottonwood, AZ 86326 | 2007-11-01 |
| 1003001033 | Country Care Inc | Assisted Living Facility | 3980 E Cassie Lane, Cottonwood, AZ 86326 | 2007-09-12 |
| 1154527778 | Laurel A Mueller | Family Medicine | 51 Brian Mickelsen Pkwy, Community Health Center of Yavapai, Cottonwood, AZ 86326 | 2007-06-21 |
| 1841401700 | Bruce Alan Moseng | Chiropractor | 240 Jennifer Lane, Ste 103, Cottonwood, AZ 86326 | 2007-05-24 |
| Find all providers in zip 86326 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699776823 | Steven J Kurzweil | Urology | 340 S Willard St, Cottonwood, AZ 86326-4126 | 2005-08-10 |
| 1801069158 | Black Hills Urology Group, P.C. | Urology | 294 W State Route 89a, Suite 208, Cottonwood, AZ 86326-3754 | 2008-04-08 |
| 1245339811 | Urology Providers of Northern Arizona | Urology | 450 S Willard St, Suite 105, Cottonwood, AZ 86326-6743 | 2006-09-21 |
| 1437121555 | Ben J Cranfill | Urology | 294 W State Route 89a, Suite 208, Cottonwood, AZ 86326-3754 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831379 | Thayne R Larson | Urology | 11900 N 102nd St, Scottsdale, AZ 85260-5928 | 2020-11-04 |
| 1386250835 | Urosouth Pllc | Urology | 6369 E Tanque Verde Rd Ste 160, Tucson, AZ 85715-3833 | 2020-09-21 |
| 1689286049 | Urosouth Pllc | Urology | 5240 E Knight Dr Ste 108, Tucson, AZ 85712-2122 | 2020-08-18 |
| 1558824763 | Kyle Scott Garcia | Urology | 1501 N Campbell Ave Rm 5325, Tucson, AZ 85724-0001 | 2019-04-14 |
| 1154886109 | Arizona Institute of Urology Pllc | Urology | 1521 E Tangerine Rd Ste 209, Oro Valley, AZ 85755-6218 | 2019-02-04 |
| 1427513472 | Arizona Institute of Urology Pllc | Urology | 395 N Silverbell Rd Ste 315, Tucson, AZ 85745-2980 | 2019-02-04 |
| 1881159838 | Arizona Institute of Urology Pllc | Urology | 516 E Whitehouse Canyon Rd Ste 160, Green Valley, AZ 85614-0543 | 2019-02-04 |
| 1558879759 | Alliance Oncology of Arizona, LLC | Urology | 2525 E Arizona Biltmore Cir Ste C236, Phoenix, AZ 85016-2130 | 2018-01-22 |
| 1659780583 | Wilfred Morris Potter | Urology | 10801 E. Happy Valley Road, #74, Scottsdale, AZ 85255 | 2014-08-05 |
| 1912327198 | Kris Miguel Cajipe | Urology | 15920 S 48th St Ste 100, Phoenix, AZ 85048-1003 | 2014-04-25 |
| Find all providers with the same taxonomy | ||||
| City | COTTONWOOD |
| Zip Code | 86326 |
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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.