NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC (NPI# 1649538612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649538612 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC |
| Other Organization Name | VERDE VALLEY MEDICAL CLINIC: ANESTHESIA |
| Practice Address |
269 South Candy Lane Cottonwood AZ 86326-4758 |
| Mailing Address |
1200 North Beaver Street Attn: Managed Care Contracting Flagstaff AZ 86001-3118 |
| Practice Telephone | 9286396150 |
| Practice Fax Number | 9286396070 |
| Mailing Telephone | 9282136543 |
| Mailing Fax Number | 9282143613 |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2019-04-17 |
| 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 | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Verde Valley Medical Clinic: Anesthesia | 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 |
269 SOUTH CANDY LANE |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326-4758 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598787889 | Stephen K Lindsey | Nurse Anesthetist, Certified Registered | 269 South Candy Lane, Cottonwood, AZ 86326-8328 | 2006-07-24 |
| 1033556089 | Northern Arizona Healthcare Provider Group, LLC | Psychiatry & Neurology | 269 South Candy Lane, Cottonwood, AZ 86326-4158 | 2013-05-31 |
| 1164780961 | Northern Arizona Healthcare Provider Group, LLC | Hospitalist | 269 South Candy Lane, Cottonwood, AZ 86326-4158 | 2012-04-30 |
| 1699033407 | Northern Arizona Healthcare Provider Group, LLC | Pathology | 269 South Candy Lane, Cottonwood, AZ 86326-4158 | 2012-04-30 |
| 1609134410 | Northern Arizona Healthcare Provider Group, LLC | Neuromusculoskeletal Medicine & OMM | 269 South Candy Lane, Cottonwood, AZ 86326-4158 | 2012-04-30 |
| 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 | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306015581 | Preston Clark Roby | Anesthesiology | 3655 E Penny Ln, Cottonwood, AZ 86326-7611 | 2008-02-21 |
| 1396741229 | David Crowell | Anesthesiology | 300 W Highway 89a, Cottonwood, AZ 86326-4104 | 2005-06-24 |
| 1235494709 | Charles A Cluff | Anesthesiology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2012-07-10 |
| 1568614410 | William Louie Quan | Anesthesiology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2008-10-22 |
| 1124203856 | Verde Valley Medical Center | Anesthesiology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2007-12-31 |
| 1497899074 | Kevin K Vakili | Anesthesiology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2007-02-16 |
| 1386797538 | Amy L Gottschalk | Anesthesiology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2007-01-19 |
| 1689731655 | Robert D Wood | Anesthesiology | 701 Lewiston Street, Cottonwood, ID 83522-0565 | 2007-01-02 |
| 1922106566 | John J Liszka-hackzell | Anesthesiology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2006-09-20 |
| 1548276249 | Robert W Gresens | Anesthesiology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2006-08-01 |
| Find all providers in COTTONWOOD | ||||
| City | COTTONWOOD |
| Zip Code | 86326 |
Please comment or provide details below to improve the information on NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC.
| 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.