Individual provider Active NPI

Minnie A Mercer, PA-C

  • Medical Physician Assistant
  • Bullhead City, AZ
National Provider Identifier
1154495356
Registry record updated Feb 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2051 Issued in AZ
Practice address
1355 Ramar Rd Ste 11
Bullhead City, AZ 86442-7100
Phone
(928) 704-9202
Fax
(928) 704-9207
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2051 AZ Primary

Addresses

Primary practice location

1355 Ramar Rd Ste 11
Bullhead City, AZ 86442-7100

Mailing address

1355 Ramar Rd Ste 11
Bullhead City, AZ 86442-7100
Phone (928) 704-9202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
380AKMDLicensed Practical Nurse
2051AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Goodyear Urgent Care LLC Past Accepting new patients
Carolina Coast Emergency Physicians LLC Past Accepting new patients
NC Emergency Physician Partners PLLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298764800000",
    "number": "1154495356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD STE 11",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-704-9202",
            "fax_number": "928-704-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD STE 11",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-704-9202",
            "fax_number": "928-704-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCER",
        "first_name": "MINNIE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2011-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2011; 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.