NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC (NPI# 1699182188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699182188 |
| Entity Type | Organization |
| Organization Name | NORTHERN ARIZONA HEALTHCARE PROVIDER GROUP, LLC |
| Other Organization Name | TRANSITIONS CLINIC |
| Practice Address |
77 W Forest Ave Flagstaff AZ 86001-1479 |
| Mailing Address |
1200 N Beaver St Attn: Managed Care Contracting Flagstaff AZ 86001-3118 |
| Practice Telephone | 9287732546 |
| Practice Fax Number | 9282136292 |
| Mailing Telephone | 9282136543 |
| Mailing Fax Number | 9282143613 |
| Enumeration Date | 2014-07-16 |
| 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 CORPORATION |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Transitions Clinic | 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 |
| 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 |
| 1508299728 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 294 W State Route 89a, Cottonwood, AZ 86326-3754 | 2013-08-12 |
| Street Address |
77 W FOREST AVE |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-1479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235133059 | Gretchen Karr Schaber | Nurse Practitioner | 77 W Forest Ave, Ste 302, Flagstaff, AZ 86001-1481 | 2005-06-09 |
| 1740728088 | Susan Dale Wall | Social Worker | 77 W Forest Ave, Suite 202, Flagstaff, AZ 86001-1479 | 2017-02-07 |
| 1326408527 | Taye Nelson | Nurse Practitioner | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2016-03-01 |
| 1639564453 | Mary Elizabeth Smith Iles | Pediatrics | 77 W Forest Ave, Flagstaff, AZ 86001 | 2015-03-30 |
| 1174914915 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 77 W Forest Ave, Flagstaff, AZ 86001-1479 | 2015-02-16 |
| 1033538533 | Neina Orrillo | Registered Nurse | 77 W Forest Ave, Suite 207, Flagstaff, AZ 86001 | 2014-04-11 |
| 1720424997 | Meredith Katz Sena | Specialist | 77 W Forest Ave, Ste 301, Flagstaff, AZ 86001-1479 | 2013-05-15 |
| 1669815825 | Lauren Diane Hayward | Pediatrics | 77 W Forest Ave, Suite 304, Flagstaff, AZ 86001-1479 | 2013-04-08 |
| 1548510019 | Mark Daniel Noorlander | Nurse Anesthetist, Certified Registered | 77 W Forest Ave, Suite 207, Flagstaff, AZ 86001-1479 | 2012-09-12 |
| 1659630028 | Erica Marissa Hansen | Audiologist | 77 W Forest Ave, Suite 305, Flagstaff, AZ 86001-1479 | 2012-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1376773341 | Tuba City Regional Health Care Corporation | Internal Medicine | 6300 N Highway 89, Flagstaff, AZ 86004 | 2009-07-23 |
| 1497866495 | Lauren Gail Breihan | Internal Medicine | 3480 E. Route 66, Flagstaff, AZ 86004 | 2006-08-31 |
| 1689602393 | Maria Cristina A De Souza | Internal Medicine | 1851 N Gemini Dr, Flagstaff, AZ 86001-1607 | 2006-06-29 |
| 1417901075 | Dennis Joseph Peat | Internal Medicine | 9925 Natchez Trail, Flagstaff, AZ 86004 | 2006-05-19 |
| 1780655159 | Michael James Keberlein | Internal Medicine | 713 N Beaver St, Flagstaff, CA 86001-3142 | 2006-02-01 |
| 1467448142 | Heather Daryl Crittenden | Internal Medicine | 3400 Escalante Ovi, Flagstaff, AZ 86001-3752 | 2005-09-27 |
| 1346241189 | Alvin B Elisco | Internal Medicine | 1200 N Beaver St, Fmc Hospitalists, Flagstaff, AZ 86001-3118 | 2005-08-02 |
| 1235138744 | Randall Perry Scott | Internal Medicine | 930 N. Switzer Canyon Dr., Suite 202, Flagstaff, AZ 86001 | 2005-07-18 |
| 1417568775 | Internal Medicine Specialty Services LLC | Internal Medicine | 1851 N Gemini Dr, Flagstaff, AZ 86001-1607 | 2020-08-11 |
| Find all providers in FLAGSTAFF | ||||
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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.