Ponderosa Pediatricss PLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PONDEROSA PEDIATRICSS PLC

Practice address

2120 Centerpointe West Drive
Prescott, AZ 86301

Phone

(928) 443-1111

Fax

(928) 443-5554

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Deann Harguess

Title

Credentialing Billing

Phone

(928) 443-1111

Specialties & licenses 1

Addresses

Other identifiers 7

Practitioners 1

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

• Ronael Eckman, MD

  • Pediatrics Physician
  • Prescott, AZ
  • NPI 1265766984
  NPD

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1124243688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 CENTERPOINTE WEST DRIVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "928-443-1111",
            "fax_number": "928-443-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 CENTERPOINTE WEST DRIVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "928-443-1111",
            "fax_number": "928-443-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONDEROSA PEDIATRICSS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "HARGUESS",
        "authorized_official_first_name": "DEANN",
        "authorized_official_title_or_position": "CREDENTIALING BILLING",
        "authorized_official_telephone_number": "928-443-1111"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1912976879",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1144299090",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1144299678",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1336118926",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1629047097",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1881653558",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1326169657",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Renee Pokrzywinski, APRN, FNP-C
• Suzann L Polk, APRN-BC
• Micaela Pommerening, PHARMD
• Mary M Poncel, M.D.
• Ponderosa Counseling of Arizona
• Pool Therapy Plus, PLLC
• Carmencita Popa, LMT
• David Pope, LASAC
• Stephanie Porcaro, LMT
• Sarah Elizabeth Posegate, OT

• Pediatrics Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.