Kokopelli Eye Care PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

KOKOPELLI EYE CARE PC

Doing business as

Kokopelli Eye Institute

Practice address

9151 W Thunderbird Rd Ste 104
Peoria, AZ 85381-4906

Phone

(844) 565-6393

Fax

(844) 329-5656

NPI assigned

Aug 6, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Michael Lee Ham, MD

Title

President

Phone

(928) 771-9000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kokopelli Eye Institute Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Kokopelli Eye Care PC

  • Durable Medical Equipment & Medical Supplies
  • Prescott, AZ
  • NPI 1841457819

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565049600000",
    "number": "1023663010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141242",
            "telephone_number": "928-771-9000",
            "fax_number": "928-759-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9151 W THUNDERBIRD RD STE 104",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814906",
            "telephone_number": "844-565-6393",
            "fax_number": "844-329-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKOPELLI EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-771-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030341",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kokopelli Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Knowledge Tutoring Services
• Julie Ann Knowles, RN
• Rachel E Knudson, LPC
• Christopher Jonathan Koch, DC
• Kelsi Madelyn Kocmoud, PA-C
• Marilyn A Koller, APRN, BCADM, CDE
• Anna Kondaurov
• Ben Michael Koolick, DDS
• Nathalie Koopmans
• Kylie Marie Koos, RN, BSN

• Durable Medical Equipment & Medical Supplies in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.