CENTRAL MOHAVE MEDICAL CLINICS LTD (NPI# 1427264480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427264480 |
Entity Type | Organization |
Organization Name | CENTRAL MOHAVE MEDICAL CLINICS LTD |
Practice Address |
1915 N Stockton Hill Rd Kingman AZ 86401-4652 |
Mailing Address |
1915 Stockton Hill Rd Kingman AZ 86401-4652 |
Practice Telephone | 9287536668 |
Practice Fax Number | 9287539797 |
Mailing Telephone | 9287536668 |
Mailing Fax Number | 9287539797 |
Enumeration Date | 2007-05-15 |
Last Update Date | 2009-09-17 |
Authorized Official Name | MICHAEL MASTAKAS (PHYSICIAN) |
Authorized Official Telephone | 9287536668 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 13105 | AZ | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 217209 | 05 |
Street Address |
1915 N STOCKTON HILL RD |
City | KINGMAN |
State | AZ |
Zip Code | 86401-4652 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225133598 | Michael Mastakas | Family Medicine | 1915 N Stockton Hill Rd, Kingman, AZ 86401-4652 | 2006-09-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
Find all providers in zip 86401 |
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 |
---|---|---|---|---|
1013559301 | Ashley Marie Eyer | Family Medicine | 1753 Airway Ave Ste A, Kingman, AZ 86409-3720 | 2019-10-08 |
1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
1780900910 | Weidner Medical Consulting Pllc | Family Medicine | 2720 E Calle Marquez, Kingman, AZ 86409-0851 | 2010-04-13 |
1760611560 | Loren Louis Augustyn | Family Medicine | 1812 North Red Barn Lane, Kingman, KS 67068-8076 | 2009-07-14 |
1245439330 | Melissa Ogden | Family Medicine | 2202 N Stockton Hill Rd, Suite 100, Kingman, AZ 86401-4622 | 2007-07-17 |
1770785362 | Kingman County Family Medicine,llc | Family Medicine | 132 West A Street, Kingman, KS 67068 | 2007-06-05 |
1083714380 | Stephen G Grillot | Family Medicine | 132 W A Ave, Kingman, KS 67068-1305 | 2006-09-25 |
1205826880 | Donald Lynn Morgan | Family Medicine | 1739 Beverly Avenue, Suite 201, Kingman, AZ 86409-3593 | 2005-10-25 |
1750378014 | Ninnescah Valley Health Systems, Inc | Family Medicine | 437 Cedar St, Kingman, KS 67068-1324 | 2005-10-03 |
1639166986 | Victoria M Moots | Family Medicine | 437 North Cedar St, Kingman, KS 67068-1324 | 2005-10-03 |
Find all providers in KINGMAN |
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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.