MR. RANDY VERNON BROGDON (NPI# 1952717761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952717761 |
| Entity Type | Individual |
| Full Name | MR. RANDY VERNON BROGDON |
| Practice Address |
500 N Us Highway 89 Prescott AZ 86313-5001 |
| Practice Telephone | 9287766112 |
| Mailing Telephone | 9287766112 |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247100000X | Radiologic Technologist | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
500 N US HIGHWAY 89 |
| City | PRESCOTT |
| State | AZ |
| Zip Code | 86313-5001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073506259 | Samuel Irwin Dolnick | Podiatrist | 500 N Us Highway 89, 5th Floor Surgery, Prescott, AZ 86313-5001 | 2005-08-23 |
| 1093322653 | Jason Kelly Ducat | Social Worker | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2020-09-28 |
| 1952926842 | Katie Elizabeth Keever | Registered Nurse | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2020-06-16 |
| 1780208918 | Melissa Marie Kelly | Registered Nurse | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2020-06-03 |
| 1063035541 | Michelle O'cleireachain | Psychologist | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2020-05-19 |
| 1538792569 | Lisa Ann Monville | Social Worker | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2020-02-18 |
| 1285274597 | Malgorzata Chmura-witusik | Registered Nurse | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2020-01-14 |
| 1740829456 | Jessica Folts | Dietitian, Registered | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2019-12-27 |
| 1578102570 | Lisa Phillips | Dietitian, Registered | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2019-12-23 |
| 1134765217 | Linh Tu | Pharmacist | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2019-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740896646 | Kelly Anne Brewer | Respiratory Therapist, Registered | 500 N. State Route 89, Cpap Clinic, Prescott, AZ 86313 | 2020-09-17 |
| 1740548908 | Jaiah Townsend | Respiratory Therapist, Registered | 500 Hwy 89n, Northern Arizona Va Hospital, Prescott, AZ 86313 | 2012-04-25 |
| 1902174618 | Rebecca Jean West | Social Worker | 500 Az-89, Bldg 155, Prescott, AZ 86313 | 2011-12-08 |
| 1740428648 | Ruthie Hunter | Social Worker | 500 North Us Highway 89, Prescott, AZ 86313 | 2009-01-30 |
| 1659586782 | Debra Lea Mcaninch | Nurse Practitioner | 500 Hwy 89 N, Prescott, AZ 86313 | 2007-05-11 |
| 1972697159 | Ted A. Mize I | Physical Therapist | 500 Us Highway 89 North, Prescott, AZ 86313 | 2006-10-03 |
| 1487755393 | Tana Bourdage-allman | Nurse Practitioner | Navahcs 550 North Highway 89, Prescott, AZ 86313 | 2006-09-25 |
| 1497859805 | Denise Perry | Dietitian, Registered | 500 Highway 89n, Va Medical Center, Prescott, AZ 86313 | 2006-09-08 |
| 1609986579 | Jeffrey C. Peters | Pharmacist | 500 N Us Hwy 89, Prescott, AZ 86313 | 2006-08-30 |
| 1578671780 | Debra M Hiller | Nurse Practitioner | Navahcs Highway 89, Prescott, AZ 86313 | 2006-08-28 |
| Find all providers in zip 86313 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386926798 | Ben S Stehower | Radiologic Technologist | 805 Whipple St Ste A, Prescott, AZ 86301-1617 | 2011-09-12 |
| 1386058568 | Cydney Lesniak | Radiologic Technologist | 500 N Us Highway 89, Prescott, AZ 86313-5001 | 2014-06-16 |
| 1174808026 | Benjamin S Stehower | Radiologic Technologist | 805 Whipple St Ste A, Prescott, AZ 86301-1617 | 2011-10-11 |
| 1851552459 | Russell Leon Palmer Jr. | Radiologic Technologist | 214 White Spar Rd, Prescott, AZ 86303-4236 | 2008-06-17 |
| 1568424315 | Prescott Medical Imaging, LLC | Radiologic Technologist | 810 Whipple St, Prescott, AZ 86301-1606 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974026 | Scottsdale Healthcare Corp | Radiologic Technologist | 20745 N Scottsdale Rd Ste 100, Scottsdale, AZ 85255-6453 | 2020-02-20 |
| 1063953081 | Karla Soward | Radiologic Technologist | 2015 N Rascon Loop, Phoenix, AZ 85037 | 2017-03-09 |
| 1710427422 | Brad Elg | Radiologic Technologist | 641 E 25th Pl, Yuma, AZ 85365-2701 | 2017-02-28 |
| 1164961355 | Kathleen Brown | Radiologic Technologist | 14226 Calabasas Road, Yucca, AZ 86438 | 2017-02-21 |
| 1124490693 | Therdo Brooks IIi | Radiologic Technologist | 14450 W Avalon Dr, Goodyear, AZ 85395-8315 | 2015-10-23 |
| 1497164388 | Michael Maestas | Radiologic Technologist | 4291 N Campbell Ave, Tucson, AZ 85719 | 2014-08-05 |
| 1679991749 | Heather Ann Lemons | Radiologic Technologist | 167 Noth Main Street, Tuba City, AZ 86045-0600 | 2014-04-04 |
| 1851607675 | Sheila Diane Andrea | Radiologic Technologist | 11405 N Crestview St., Flagstaff, AZ 86004-5215 | 2010-08-31 |
| 1871818492 | Stacy Talahytewa II | Radiologic Technologist | Hwy 264 Mile Post 388, Polacca, AZ 86042 | 2010-04-07 |
| 1891010807 | Marjorie Chinnock | Radiologic Technologist | M.p. 388 State Route 264, Polacca, AZ 86042-4000 | 2010-04-01 |
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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.