Active NPI
Sage Wilcox
- Student in an Organized Health Care Education/Training Program
- Flagstaff, AZ
National Provider Identifier
1174360127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 208 East Pine Knoll Drive
Building 66
Flagstaff, AZ 86001 - Phone
- (928) 523-7147
- NPI assigned
- Jul 9, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
208 East Pine Knoll Drive
Building 66
Flagstaff, AZ 86001
Mailing address
208 East Pine Knoll Drive
Building 66
Flagstaff, AZ 86001
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720483200000",
"number": "1174360127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 EAST PINE KNOLL DRIVE",
"address_2": "BUILDING 66",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 EAST PINE KNOLL DRIVE",
"address_2": "BUILDING 66",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86001",
"telephone_number": "928-523-7147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "SAGE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-09",
"last_updated": "2024-07-09",
"certification_date": "2024-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"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 Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.