NPIMap

Organization Active NPI

Arizona Emergency Medicine Specialists PC

  • Emergency Medicine Physician
  • Lake Havasu City, AZ
National Provider Identifier
1134439706
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
ARIZONA EMERGENCY MEDICINE SPECIALISTS PC
Practice address
101 Civic Center LN
Lake Havasu City, AZ 86403-5607
Phone
(928) 855-8185
NPI assigned
Oct 18, 2010
Last updated
Nov 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Authorized official

Name
Brian Scott, DONPI 1578639969
Title
President
Phone
(928) 230-3653

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
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Mailing address

PO Box 11577
Daytona Beach, FL 32120-1577
Phone (386) 274-7800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110208000837 AZ Part B Supplier - Clinic/Group Practice 8921295684 Receives reassigned benefits from 81 practitioners
Practice locations: Lake Havasu City, AZ

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 81

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.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605830400000",
    "number": "1134439706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11577",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321201577",
            "telephone_number": "386-274-7800",
            "fax_number": "386-274-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-855-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA EMERGENCY MEDICINE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-230-3653",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; 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.