Jeffrey C Proudfoot, D.O.

Primary specialty

Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X

License

2668 Issued in AZ

Practice address

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Phone

(602) 546-1000

NPI assigned

Mar 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jproudfoot5079@direct.valleywisehealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• District Medical Group, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • Phoenix, AZ
  • NPI 1336472448
  Medicare reassignment NPD
• District Medical Group, Inc

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1144624339
  NPD
• District Medical Group, Inc

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1295968162
  NPD
• Desert Valley Urgent Care, PLLC

  • Urgent Care Clinic/Center
  • Chandler, AZ
  • NPI 1811160492
  NPD (past)
• Hualapai Emergency Physician Partners PLLC

  • Emergency Medicine Physician
  • Kingman, AZ
  • NPI 1881827806
  NPD (past)
• Mesa General Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1568473940
  NPD (past)
• Mountain Vista Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1164642963
  NPD (past)

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043271463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "address_2": "BLDG. C MANAGED CARE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-546-0486",
            "fax_number": "602-546-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-546-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUDFOOT",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "AZ",
            "license": "2668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177255",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Marie Prosser, CTRS
• Prostate Diagnostics, LLC
• Prostate Solutions of Arizona, P.C.
• Protherapy Staffing
• Brandi Protonentis
• Proudly Arizona LLC
• Providence General Medicine
• Providence General Medicine, PC
• Providence Health Group LLC (Genesis Wellness & Pain Management Center)
• Providence Hospice and Palliative Care Inc

• Pediatric Emergency Medicine (Pediatrics) Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pediatric Emergency Medicine (Pediatrics) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.