VERDE VALLEY MEDICAL CENTER (NPI# 1851545073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851545073 |
| Entity Type | Organization |
| Organization Name | VERDE VALLEY MEDICAL CENTER |
| Other Organization Name | NAH PHYSICIAN GROUP - NEUROLOGY |
| Practice Address |
269 S Candy Ln Cottonwood AZ 86326-4158 |
| 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 | 2008-11-14 |
| Last Update Date | 2019-04-15 |
| Authorized Official Name | RONALD F HAASE (NAH CHIEF SYSTEMS OFFICER) |
| Authorized Official Telephone | 9287732059 |
| Is Organization Subpart | Y |
| Parent Organization Name | VERDE VALLEY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
AZ | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| NAH Physician Group - Neurology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538608716 | Verde Valley Medical Center | General Acute Care Hospital | 3700 W Highway 89a, Sedona, AZ 86336-4937 | 2017-02-21 |
| 1154768190 | Verde Valley Medical Center | Radiology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2013-05-31 |
| 1184955932 | Verde Valley Medical Center | Hospitalist | 269 S Candy Ln, Vvmc Hospitalist, Cottonwood, AZ 86326-4158 | 2010-01-19 |
| 1134457666 | Verde Valley Medical Center | Orthopaedic Surgery | 450 S Willard St, Cottonwood, AZ 86326 | 2009-11-20 |
| 1881822435 | Verde Valley Medical Center | Family Medicine | 450 S Willard St, Ste 115, Cottonwood, AZ 86326 | 2009-06-22 |
| 1780821074 | Verde Valley Medical Center | Pathology | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2009-01-08 |
| 1699942771 | Verde Valley Medical Center | Internal Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2008-05-08 |
| 1821260001 | Verde Valley Medical Center | Clinic/Center | 294 W Highway 89a, Cottonwood, AZ 86326-3754 | 2008-03-28 |
| 1356510010 | Verde Valley Medical Center | Durable Medical Equipment & Medical Supplies | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2008-02-27 |
| 1972789667 | Verde Valley Medical Center | Ambulance | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2008-01-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VERDE VALLEY MEDICAL CENTER | 269 S Candy Ln, Cottonwood, AZ 86326-4158 |
| Street Address |
269 S CANDY LN |
| City | COTTONWOOD |
| State | AZ |
| Zip Code | 86326-4158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356345383 | Eugene M.r. Charlebois | Emergency Medicine | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2005-06-08 |
| 1306463740 | Riley Benjamin Johnson | Dietitian, Registered | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-07-01 |
| 1821619891 | Joshua Thomas Haywood | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-30 |
| 1396364162 | Jeremy Schmoyer | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-13 |
| 1144849993 | Miranda Rose Anderson | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-12 |
| 1659900876 | Eddie Khav | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4170 | 2020-04-08 |
| 1790314961 | Michelle Anne Pope | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2020-04-08 |
| 1699320390 | Emily Kathryn Danca | Dietitian, Registered | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-08-08 |
| 1760036909 | Tarra Denise Young | Nurse Practitioner | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-07-25 |
| 1275195950 | Samer Saeed Hasson | Student in an Organized Health Care Education/Training Program | 269 S Candy Ln, Cottonwood, AZ 86326-4158 | 2019-07-02 |
| Find all providers in the same location | ||||
| 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 | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760677900 | Weihong Pan | Psychiatry & Neurology | 450 S Willard St, Ste 107, Cottonwood, AZ 86326-6743 | 2007-09-11 |
| 1396963914 | Paula K Rauschkolb | Psychiatry & Neurology | 340 S Willard St, Cottonwood, AZ 86326-4126 | 2007-04-20 |
| 1083686265 | Elwood Wilbur Hopkins, IIi | Psychiatry & Neurology | 450 S Willard St, Cottonwood, AZ 86326-6743 | 2006-02-02 |
| 1538165592 | Barry J Bergen | Psychiatry & Neurology | 701 Lewiston St, Cottonwood, ID 83522-9750 | 2005-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437772027 | Alobaidy Neurology Consultants Pllc | Psychiatry & Neurology | 3719 E Louise Dr, Phoenix, AZ 85050-8314 | 2020-05-18 |
| 1619509718 | De Ocampo Medical Partners Pllc | Psychiatry & Neurology | 7500 N Dreamy Draw Dr Ste 133, Phoenix, AZ 85020-4668 | 2020-02-06 |
| 1861024184 | Arizona Epilepsy Associates LLC | Psychiatry & Neurology | 2501 E Southern Ave Ste 16, Tempe, AZ 85282-7667 | 2020-02-05 |
| 1063051514 | Spine Builders, LLC | Psychiatry & Neurology | 9700 N 91st St Ste B108, Scottsdale, AZ 85258-5036 | 2020-01-02 |
| 1811539901 | Arizona Neurological Services Pllc | Psychiatry & Neurology | 14001 N 7th St Bldg F1, Phoenix, AZ 85022-4382 | 2019-10-10 |
| 1366905465 | Neurology Associates of Scottsdale Arizona, PC | Psychiatry & Neurology | 9817 N 95th St Ste 115, Scottsdale, AZ 85258-4587 | 2019-04-08 |
| 1699243071 | Surgical Neuromonitoring Solutions, LLC | Psychiatry & Neurology | 6926 North Hayden Road C4-461, Scottsdale, AZ 85251 | 2018-11-05 |
| 1295202828 | Neuromonitoring Surgical Services, LLC | Psychiatry & Neurology | 13370 North Hayden Road #133-269, Scottsdale, AZ 85251 | 2018-11-01 |
| 1649751082 | Jennifer Victoria Robblee | Psychiatry & Neurology | 240 W Thomas Rd Fl 4, Phoenix, AZ 85013-4407 | 2018-08-23 |
| 1992294607 | Kathryn Clare Krulisky | Psychiatry & Neurology | 1501 N Campbell Ave Rm 6204a, Tucson, AZ 85724-0001 | 2018-05-08 |
| 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.