NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC (NPI# 1699033407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699033407 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC |
| Other Organization Name | VERDE VALLEY MEDICAL CLINIC: PATHOLOGY |
| Practice Address |
269 South Candy Lane Cottonwood AZ 86326-4158 |
| Mailing Address |
1200 North Beaver Street Attn: Managed Care Contracting Flagstaff AZ 86001-3118 |
| Practice Telephone | 9286396180 |
| Practice Fax Number | 9286396070 |
| Mailing Telephone | 9282136543 |
| Mailing Fax Number | 9282143613 |
| Enumeration Date | 2012-04-30 |
| 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 | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Verde Valley Medical Clinic: Pathology | 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 | 86326-4158 |
| 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 |
| 1609134410 | Northern Arizona Healthcare Provider Group, LLC | Neuromusculoskeletal Medicine & OMM | 269 South Candy Lane, Cottonwood, AZ 86326-4158 | 2012-04-30 |
| 1649538612 | Northern Arizona Healthcare Provider Group, LLC | Anesthesiology | 269 South Candy Lane, Cottonwood, AZ 86326-4758 | 2012-04-27 |
| 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 | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780821074 | Verde Valley Medical Center | Pathology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2009-01-08 |
| 1366505364 | Mark E Miller | Pathology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2006-12-19 |
| 1275511156 | Gregory Daniel Novak | Pathology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2006-01-03 |
| 1356323232 | Anna Pacelli | Pathology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881200632 | Eric David Peters | Pathology | 11545 E Quiet Valley Pl, Tucson, AZ 85749-8884 | 2020-09-17 |
| 1609434794 | Peak Diagnostic Services LLC | Pathology | 3033 N 44th St Ste 200, Phoenix, AZ 85018-7244 | 2019-06-03 |
| 1144638008 | Michael Moore | Pathology | 8796 N Western Red Cedar Dr, Tucson, AZ 85743-7146 | 2014-07-23 |
| 1356683155 | Belinda Liu Sun | Pathology | 1501 N Campbell Ave Rm 5205, Tucson, AZ 85724-7232 | 2013-03-20 |
| 1669717815 | Guadalupe Hortencia Manriquez | Pathology | 7601 N Calle Sin Envidia, 31, Tucson, AZ 85718-1271 | 2012-11-29 |
| 1407164486 | Aztec Pathology LLC | Pathology | 2538 E University Dr Ste 100, Phoenix, AZ 85034-6925 | 2010-09-23 |
| 1336471846 | Peter Salomon | Pathology | 6344 E Miramar Dr, Tucson, AZ 85715-3115 | 2010-02-08 |
| 1427387372 | Meryl Harold Haber | Pathology | 8464 E Charter Oak Dr, Scottsdale, AZ 85260-5315 | 2009-12-23 |
| 1538492400 | Paul Boschen Visconti | Pathology | 33619 N 79th Way, Scottsdale, AZ 85266-4241 | 2009-09-10 |
| 1417186305 | Brent J Bedke | Pathology | 1740 Sycamore Ave Ste C, Kingman, AZ 86409-1039 | 2009-07-13 |
| 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.