MARK E DONNELLY (NPI# 1902802192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902802192 |
| Entity Type | Individual |
| Full Name | MARK E DONNELLY |
| Credential | M.D. |
| Practice Address |
1215 N Beaver St Ste 202 Flagstaff AZ 86001-3126 |
| Mailing Address |
1200 N Beaver St Payer Credentialing Flagstaff AZ 86001-3118 |
| Practice Telephone | 9287732200 |
| Practice Fax Number | 9287732201 |
| Mailing Telephone | 9287732559 |
| Mailing Fax Number | 9282136292 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2017-03-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 18917 | AZ | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 286874 | 05 | |
| AZ | RAILROAD MEDICARE | P01112889 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689155301 | Mark C Donnelly | Pharmacist | 2981 Ford Street Ext, Ogdensburg, NY 13669-3474 | 2018-08-22 |
| 1013394576 | Mark C. Donnelly | Family Medicine | 888 S Rancho Dr, Las Vegas, NV 89106 | 2015-05-04 |
| 1902133978 | Mark Donnelly | Acupuncturist | 177 Conklin St, Farmingdale, NY 11735-2501 | 2009-11-11 |
| 1700820784 | Mark W. Donnelly | Emergency Medicine | 525 N Santiam Hwy, Lebanon, OR 97355-4363 | 2006-06-16 |
| Street Address |
1215 N BEAVER ST STE 202 |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194227918 | Holly Offerman | Speech-Language Pathologist | 1215 N Beaver St, Flagstaff, AZ 86001-3126 | 2018-03-07 |
| 1588118111 | Nathan Alan Moss | Nurse Practitioner | 1215 N Beaver St, Flagstaff, AZ 86001-3126 | 2016-08-11 |
| 1598113672 | Mark Weststeyn | Physical Therapist | 1215 N Beaver St, Flagstaff, AZ 86001-3126 | 2016-05-30 |
| 1063839009 | Angela Hansen | Dietitian, Registered | 1215 N Beaver St, Flagstaff, AZ 86001-3126 | 2014-03-27 |
| 1568887891 | Dore Davidson | Speech-Language Pathologist | 1215 N Beaver St, Flagstaff, AZ 86001 | 2014-02-24 |
| 1821437500 | Diane Margaret Van Cornewal | Counselor | 1215 N Beaver St, Flagstaff Medical Center, Flagstaff, AZ 86001-3126 | 2013-06-17 |
| 1992064927 | Northern Arizona Healthcare Provider Group, LLC | Internal Medicine | 1215 N Beaver St, Flagstaff, AZ 86001-3126 | 2012-05-11 |
| 1619120847 | Nicole Sasser | Speech-Language Pathologist | 1215 N Beaver St, Flagstaff, AZ 86001-3126 | 2008-10-31 |
| 1477706281 | Cintamani H. Ellsworth | Speech-Language Pathologist | 1215 N Beaver St, Flagstaff, AZ 86001-3126 | 2008-10-24 |
| 1255598900 | Nicole Renee Sydow | Surgery | 1215 N Beaver St, Suite 203, Flagstaff, AZ 86001-3126 | 2008-05-20 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639437619 | Jayece R. Laudner | Specialist | 1485 N. Turquoise Dr., Suite 220, Flagstaff, AZ 86001 | 2012-04-27 |
| 1306145859 | Alexander Hu | Specialist | 399 S Malpais Ln, Flagstaff, AZ 86001-6218 | 2011-03-23 |
| 1932427077 | Amy Horn | Specialist | 408 N Kendrick St Ste 1, Flagstaff, AZ 86001-1582 | 2010-05-13 |
| 1053550061 | Douglas Crabbe | Specialist | 240 Buffalo Trl, Flagstaff, AZ 86001-9512 | 2009-02-13 |
| 1669617270 | Perring Medical Services, PC | Specialist | 813 N Beaver St, Flagstaff, AZ 86001-3105 | 2008-12-10 |
| 1386825339 | B. Cody Wright Md PC | Specialist | 121 E Birch Ave Ste 503, Flagstaff, AZ 86001-4621 | 2007-11-19 |
| 1770762841 | Cardiac & Peripheral Vascular Specials of Northern Arizona | Specialist | 1515 E Cedar Ave Ste D-2, Flagstaff, AZ 86004-1638 | 2007-10-25 |
| 1679794259 | David G Mueller | Specialist | 5100 W. Kiltie Lane, Flagstaff, AZ 86001 | 2007-05-01 |
| 1073631388 | Karen Deborah Furr | Specialist | 8353 Jupiter Ln, Flagstaff, AZ 86004-1394 | 2007-03-26 |
| 1285784082 | Seaside Sanctuary Clinic LLC | Specialist | 2401 W Route 66, #24, Flagstaff, AZ 86001-8761 | 2007-01-12 |
| 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.