NPIMap

Organization Active NPI

Northern Arizona Healthcare

  • Physician Assistant
  • Cottonwood, AZ
National Provider Identifier
1063137883
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
NORTHERN ARIZONA HEALTHCARE
Practice address
340 S Willard St
Cottonwood, AZ 86326-4126
Phone
(928) 639-5580
Fax
(928) 639-6541
NPI assigned
Oct 4, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Elaine Mary Accomando, PA-CNPI 1033189444
Title
Physician Assistant
Phone
(928) 639-5580

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

340 S Willard St
Cottonwood, AZ 86326-4126

Mailing address

340 S Willard St
Cottonwood, AZ 86326-4126
Phone (928) 639-5580

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a87a863d-8666-48d4-bbb9-1908bfb27a5f/

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1063137883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S WILLARD ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264126",
            "telephone_number": "928-639-5580",
            "fax_number": "928-639-6541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S WILLARD ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264126",
            "telephone_number": "928-639-5580",
            "fax_number": "928-639-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ARIZONA HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "ACCOMANDO",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "928-639-5580",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.