NPIMap

Organization Active NPI

Level 4 Medical Professional Corporation

Doing business as Foothills Walk-in Medical and Urgent Care

  • Basic Emergency Medical Technician
  • Yuma, AZ
National Provider Identifier
1023041654
Registry record updated Sep 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
OTC2699 Issued in AZ
Legal business name
LEVEL 4 MEDICAL PROFESSIONAL CORPORATION
Doing business as
Foothills Walk-in Medical and Urgent Care
Practice address
11274 S Fortuna Rd
Ste I 4
Yuma, AZ 85367-7847
Phone
(928) 345-2150
Fax
(928) 345-2151
NPI assigned
Jul 8, 2006
Last updated
Sep 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David E Smock, M.DNPI 1710980206
Title
Medical Director
Phone
(928) 345-2150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X OTC2699 AZ Primary

Addresses

Primary practice location

11274 S Fortuna Rd
Ste I 4
Yuma, AZ 85367-7847

Mailing address

11274 S Fortuna Rd
Ste I 4
Yuma, AZ 85367-7847
Phone (928) 345-2150

Other names 1

  • FOOTHILLS WALK-IN MEDICAL AND URGENT CARE Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505088000000",
    "number": "1023041654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11274 S FORTUNA RD",
            "address_2": "STE I 4",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853677847",
            "telephone_number": "928-345-2150",
            "fax_number": "928-345-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11274 S FORTUNA RD",
            "address_2": "STE I 4",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853677847",
            "telephone_number": "928-345-2150",
            "fax_number": "928-345-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEVEL 4 MEDICAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2017-09-11",
        "status": "A",
        "authorized_official_last_name": "SMOCK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "928-345-2150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "AZ",
            "license": "OTC2699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOTHILLS WALK-IN MEDICAL AND URGENT CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.