Organization Active NPI

Neurological & Headache Disorders PC

  • Specialist
  • Kingman, AZ
National Provider Identifier
1184823320
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25814 Issued in AZ
Legal business name
NEUROLOGICAL & HEADACHE DISORDERS PC
Practice address
1708 Sycamore Ave
Kingman, AZ 86409-0927
Phone
(928) 757-7100
Fax
(928) 757-7255
NPI assigned
Jul 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Authorized official

Name
Dr. Munawar A Paracha, M.D.NPI 1912962549
Title
President
Phone
(928) 757-7100

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 25814 AZ Primary

Addresses

Primary practice location

1708 Sycamore Ave
Kingman, AZ 86409-0927

Mailing address

1708 Sycamore Ave
Kingman, AZ 86409-0927
Phone (928) 757-7100

Other identifiers 1

IdentifierTypeStateIssuer
430075MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180917001526 AZ Part B Supplier - Clinic/Group Practice 8123379088 Receives reassigned benefits from 1 practitioner
Practice locations: Kingman, AZ

National Provider Directory

National Provider Directory

Locations

1708 Sycamore Ave
Kingman, AZ 86409
Phone (928) 757-7100

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536883200000",
    "number": "1184823320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 SYCAMORE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090927",
            "telephone_number": "928-757-7100",
            "fax_number": "928-757-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 SYCAMORE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090927",
            "telephone_number": "928-757-7100",
            "fax_number": "928-757-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGICAL & HEADACHE DISORDERS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2018-09-14",
        "status": "A",
        "authorized_official_last_name": "PARACHA",
        "authorized_official_first_name": "MUNAWAR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-757-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "25814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430075",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.