Embry Riddle Wellness Center

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

EMBRY RIDDLE WELLNESS CENTER

Practice address

3700 Willow Creek Rd
Prescott, AZ 86301-3721

Phone

(928) 777-6653

NPI assigned

Feb 19, 2013

Last updated

Feb 19, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra Palmer, RNNPI 1740623339

Title

Director

Phone

(928) 777-6653

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 7

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.

• Sandra F Palmer, RN

  • Registered Nurse
  • Prescott, AZ
  • NPI 1740623339
  NPD (past) Authorized official
• Ellen F Bunch, MD, FIM, BSE, BAA

  • Family Medicine Physician
  • Prescott, AZ
  • NPI 1730289380
  NPD (past)
• Christina Elizabeth Caple, RD, MS

  • Registered Dietitian
  • Glendale, AZ
  • NPI 1497189609
  NPD (past)
• Joanne Hird

  • Professional Counselor
  • Prescott, AZ
  • NPI 1831613140
  NPD (past)
• Kara E Johnson, M.D.

  • Internal Medicine Physician
  • Prescott Valley, AZ
  • NPI 1942251996
  NPD (past)
• Leanne Theresa Lobue, ARNP

  • Family Nurse Practitioner
  • Iowa City, IA
  • NPI 1609313923
  NPD (past)
• Matthew Miller

  • Professional Counselor
  • Breaux Bridge, LA
  • NPI 1538682364
  NPD (past)

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1104166727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863013721",
            "telephone_number": "928-777-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863013721",
            "telephone_number": "928-777-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBRY RIDDLE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "928-777-6653",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELLEN BUNCH MD TYPE I NPI",
            "identifier": "1730289380",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PETER POWERS MD TYPE I NPI",
            "identifier": "1649376831",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Elliott, RN
• Melissa Ellis
• Taylor Nicole Ellison, PHARMD
• Maryam Emami, MD
• Embark Recovery LLC
• Emeritus Corporation (The Peridot Assisted Living Community)
• Margarita Erdahl
• Eric Baumann MD, PC
• Eric R Nelson MD PC
• Carolyn Ruth Ernst, RN

• General Practice Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.