PRESCOTT EYE CARE & SURGICAL CENTER, PC (NPI# 1740431378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740431378 |
| Entity Type | Organization |
| Organization Name | PRESCOTT EYE CARE & SURGICAL CENTER, PC |
| Practice Address |
3769 Crossing Drive Prescott AZ 86305-1606 |
| Mailing Address |
3192 Willow Creek Rd Prescott AZ 86301-6610 |
| Practice Telephone | 9284459200 |
| Practice Fax Number | 9287728107 |
| Mailing Telephone | 9284451234 |
| Mailing Fax Number | 9287728107 |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2016-05-24 |
| Authorized Official Name | STEVEN W. MORTENSON (CEO) |
| Authorized Official Telephone | 9284459200 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1100X |
Technician/Technologist Specialization: Ophthalmic |
Eye and Vision Services Providers |
| Street Address |
3769 CROSSING DRIVE |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86305-1606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295722528 | James Archie Ramaglino | Nurse Practitioner | 3769 Crossing Drive, Suite D, Prescott, AZ 86305-7121 | 2005-10-03 |
| 1417016759 | Frank J Colella | Nurse Practitioner | 3769 Crossing Drive, Suite B, Prescott, AZ 86305-3700 | 2006-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972005395 | Granite View Adult Care Home LLC | Assisted Living Facility | 7105 Williamson Valley Road, Prescott, AZ 86305 | 2018-03-01 |
| 1215468095 | Valerie Williams | Occupational Therapist | 926 S. Hinman Dr., Prescott, AZ 86305 | 2017-03-23 |
| 1174073837 | Caspian Gleam Medical Center LLC | Clinic/Center | 3130 Stillwater Drive, Suite B, Prescott, AZ 86305 | 2016-10-06 |
| 1114388634 | Marla Beth Perkins | Speech-Language Pathologist | 3160 Stillwater Dr., Prescott, AZ 86305 | 2016-03-10 |
| 1790159853 | Michele A. Bibeau, D.d.s. | Dentist | 1058 Fair Street, Suite A, Prescott, AZ 86305 | 2015-11-30 |
| 1609264837 | Integrative Pain Centres of Prescott | Pain Medicine | 3769 Crossings Drive, Suite B, Integrative Pain Centres of Prescott, Prescott, AZ 86305 | 2014-12-22 |
| 1649697251 | Sharon Marilyn Jackson | Counselor | 3636 Crossings Drive, Prescott, AZ 86305 | 2014-03-20 |
| 1215351259 | Stefanie Maneval | Registered Nurse | 900 Iron Springs Rd, Prescott, AZ 86305 | 2014-02-11 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1871857359 | Neal Herbert Segovia Cabaluna | Internal Medicine | 3773 Crossings Dr Ste C, Prescott, AZ 86305 | 2012-06-28 |
| Find all providers in zip 86305 | ||||
| Taxonomy Code | 156FX1100X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Ophthalmic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780902320 | Star Pupil | Technician/Technologist | 20201 N Scottsdale Healthcare Dr, #150, Scottsdale, AZ 85255-4134 | 2010-05-06 |
| 1265614937 | Placido LLC | Technician/Technologist | 13624 W Camino Del Sol Ste 200, Sun City West, AZ 85375-3401 | 2007-12-04 |
Please comment or provide details below to improve the information on PRESCOTT EYE CARE & SURGICAL CENTER, 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.