Organization Active NPI

Lonny Elson Family Healthcare

  • Primary Care Clinic/Center
  • Flagstaff, AZ
National Provider Identifier
1104502418
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LONNY ELSON FAMILY HEALTHCARE
Practice address
1016 W University Ave Ste 206
Flagstaff, AZ 86001-2996
Phone
(928) 266-1530
NPI assigned
Jun 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Mr. Lonny D Elson, FNP-CNPI 1912192048
Title
Owner
Phone
(928) 266-1530

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1016 W University Ave Ste 206
Flagstaff, AZ 86001-2996

Mailing address

1016 W University Ave Ste 206
Flagstaff, AZ 86001-2996
Phone (928) 266-1530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230816001004 AZ Part B Supplier - Clinic/Group Practice 3274995790 Receives reassigned benefits from 1 practitioner
Practice locations: Flagstaff, AZ

National Provider Directory

National Provider Directory

Locations

1016 W University Ave
Ste 101206
Flagstaff, AZ 86001

Practitioners & affiliated clinicians

Practitioners 2

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": "1687392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1104502418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 W UNIVERSITY AVE STE 206",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012996",
            "telephone_number": "928-266-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 W UNIVERSITY AVE STE 206",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012996",
            "telephone_number": "928-266-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONNY ELSON FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-22",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "ELSON",
        "authorized_official_first_name": "LONNY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-266-1530",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.