KOKOPELLI EYE CARE PC (NPI# 1528005444) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528005444 |
| Entity Type | Organization |
| Organization Name | KOKOPELLI EYE CARE PC |
| Practice Address |
2820 N Glassford Hill Rd Suite 101 Prescott Valley AZ 86314-1242 |
| Practice Telephone | 9287755606 |
| Practice Fax Number | 9287724999 |
| Mailing Telephone | 9287755606 |
| Mailing Fax Number | 9287724999 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2012-07-16 |
| Authorized Official Name | DR. MICHAEL LEE HAM (PRESIDENT) |
| Authorized Official Telephone | 9287755606 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 26357 | AZ | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023663010 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 9151 W Thunderbird Rd Ste 104, Peoria, AZ 85381-4906 | 2019-08-06 |
| 1619470085 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 5140 W Peoria Ave Ste 116, Glendale, AZ 85302-1631 | 2018-03-13 |
| 1669975157 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 16605 E Palisades Blvd Ste 152, Fountain Hills, AZ 85268-3717 | 2018-03-12 |
| 1184175416 | Kokopelli Eye Care PC | Eyewear Supplier (Equipment, not the service) | 15033 W Bell Rd Ste 150, Surprise, AZ 85374-3262 | 2016-10-21 |
| 1396294583 | Kokopelli Eye Care PC | Eyewear Supplier (Equipment, not the service) | 2403 N Stockton Hill Rd, Suite 1, Kingman, AZ 86401-4188 | 2016-09-28 |
| 1114140019 | Kokopelli Eye Care PC | Clinic/Center | 412 Whipple St, Prescott, AZ 86301-1712 | 2007-04-10 |
| 1174026546 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 25 W Yavapai St, Wickenburg, AZ 85390-3280 | 2018-03-13 |
| 1750894655 | Kokopelli Eye Care PC | Eyewear Supplier (Equipment, not the service) | 2820 N Glassford Hill Rd, Prescott Valley, AZ 86314-1242 | 2017-11-14 |
| 1841457819 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 412 Whipple St, Prescott, AZ 86301-1712 | 2008-05-19 |
| Street Address |
2820 N GLASSFORD HILL RD SUITE 101 |
| City | PRESCOTT VALLEY |
| State | AZ |
| Zip Code | 86314-1242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750385647 | Michael Lee Ham | Ophthalmology | 2820 N Glassford Hill Rd, Ste 101, Prescott Valley, AZ 86314-2256 | 2005-06-08 |
| 1750894655 | Kokopelli Eye Care PC | Eyewear Supplier (Equipment, not the service) | 2820 N Glassford Hill Rd, Prescott Valley, AZ 86314-1242 | 2017-11-14 |
| 1043477847 | Kokopelli Eye Care Optical Dept | Technician/Technologist | 2820 N Glassford Hill Rd, Suite 101, Prescott Valley, AZ 86314-1242 | 2008-05-20 |
| 1699956813 | Associated Retina Consultants, Ltd. | Ophthalmology | 2820 N Glassford Hill Rd, Prescott Valley, AZ 86314-1242 | 2007-11-15 |
| 1013038009 | Joanne C Hopman | Optometrist | 2820 N Glassford Hill Rd, Suite 101, Prescott Valley, AZ 86314-1242 | 2007-04-03 |
| 1205858875 | Kokopelli Eye Care Surgery Center | Clinic/Center | 2820 N Glassford Hill Rd, Prescott Valley, AZ 86314-1242 | 2006-07-24 |
| 1992701494 | Nicholas Leo Koshuta | Optometrist | 2820 N Glassford Hill Rd, Ste 101, Prescott Valley, AZ 86314-2256 | 2005-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992326029 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 3001 N. Mountain View Rd, Prescott Valley, AZ 86314 | 2020-04-29 |
| 1124666516 | Best Care Behavioral Homes LLC | Community/Behavioral Health | 5385 W Saddleback Drive, Prescott Valley, AZ 86314 | 2019-12-16 |
| 1912541558 | The Stateserv Companies, LLC | Durable Medical Equipment & Medical Supplies | 8926 E. Long Mesa Drive, Prescott Valley, AZ 86314 | 2019-11-06 |
| 1003398983 | Richard Telck | Pharmacist | 7720 E. Highway 69, Prescott Valley, AZ 86314 | 2018-09-06 |
| 1912493065 | Akdhc,llc | Internal Medicine | 7862 E Florentine Rd, Suite 120, Prescott Valley, AZ 86314 | 2018-07-02 |
| 1700377983 | Pronghorn Psychiatry | Clinic/Center | 5940 E. Copper Hill Dr, Suite E, Prescott Valley, AZ 86314 | 2018-05-23 |
| 1689185126 | Thumb Butte Urgent Care | Clinic/Center | 6496 East Highway 69, Prescott Valley, AZ 86314 | 2017-10-23 |
| 1740738046 | Janine Kauffmann | Pharmacist | 7720 East Highway 69, Prescott Valley, AZ 86314 | 2016-09-14 |
| 1528415650 | Nazcare, Inc. | Exclusive Provider Organization | 8200 E. Jacque Dr., Prescott Valley, AZ 86314 | 2016-05-18 |
| 1184087009 | William Beverly | Marriage & Family Therapist | 8603 E. Eastridge Dr., Ste A, Prescott Valley, AZ 86314 | 2016-03-29 |
| Find all providers in zip 86314 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164803433 | Nicole Scott | Specialist | 8603 E. Eastridge Drive, Suite A, Prescott Valley, AZ 86314 | 2015-06-12 |
| 1942608351 | Granite Orthopaedics, Pllc | Specialist | 2960 N Centre Ct, Prescott Valley, AZ 86314-2295 | 2014-12-17 |
| 1417364266 | Phyllis Arellanes | Specialist | 7426 E Horseshoe Ln, #b, Prescott Valley, AZ 86314-3297 | 2014-07-14 |
| 1548407091 | Carol Ann Pitts | Specialist | 8412 Sommer Dr, Prescott Valley, AZ 86314 | 2009-01-20 |
| 1568642643 | Denise N Antonio | Specialist | 1098 N Hobble Strap St, Prescott Valley, AZ 86314-1445 | 2007-11-06 |
| 1417174541 | Mark Haag | Specialist | 3100 N Mountain View Dr, Prescott Valley, AZ 86314-2572 | 2007-04-19 |
| 1376681197 | Madelynn Grubbs | Specialist | 5427 N Long Rifle Rd, Prescott Valley, AZ 86314-4263 | 2007-02-02 |
| 1821158916 | Nancy Renee Smith | Specialist | 5347 N Stetson Dr, Prescott Valley, AZ 86314 | 2006-12-11 |
| 1154481240 | Kelley Lynn Haag | Specialist | 3100 Mountain View, Prescott Valley, AZ 86314-2572 | 2006-12-11 |
| 1508885047 | Mark B Davis | Specialist | 3237 N Windsong Drive, Prescott Valley, AZ 86314 | 2006-07-18 |
| Find all providers in PRESCOTT VALLEY | ||||
| City | PRESCOTT VALLEY |
| Zip Code | 86314 |
Please comment or provide details below to improve the information on KOKOPELLI EYE CARE PC.
| 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.