Caspian Gleam Medical Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CASPIAN GLEAM MEDICAL CENTER LLC

Practice address

3130 Stillwater Drive, Suite B
Prescott, AZ 86305

Phone

(801) 884-9687

NPI assigned

Oct 6, 2016

Organization subpart

No

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

Authorized official

Name

Farbod Misaghian

Title

Owner

Phone

(801) 884-9687

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Rahmat Afrasiabi, M.D.

  • Allergy Physician
  • Prescott, AZ
  • NPI 1811961204
  NPD

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1174073837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 ROSE LN",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053744",
            "telephone_number": "801-884-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 STILLWATER DRIVE, SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "801-884-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASPIAN GLEAM MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "MISAGHIAN",
        "authorized_official_first_name": "FARBOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-884-9687"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberlyn Joy Carter, NP
• Kyle L. Carter, M.D.
• Denise Cartier
• Carmen Cartterfield
• Kelly Ann Casey, PT
• Alexandra L Cassidy, LCSW
• Raul A. Castillo, M.D.
• Catherine Young PLLC
• Catholic Charities Community Services
• Catholic Charities Community Services, Inc

• Clinic/Center in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.