NPIMap

Organization Active NPI

Mountain Heart Cath Lab

  • Ambulatory Surgical Clinic/Center
  • Flagstaff, AZ
National Provider Identifier
1194988824
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
30420 Issued in AZ
Legal business name
MOUNTAIN HEART CATH LAB
Practice address
2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone
(928) 226-6400
Fax
(928) 226-6411
NPI assigned
Jul 2, 2008
Last updated
Apr 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Authorized official

Name
Suzanne R Duval
Title
Credentialing
Phone
(928) 226-6400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 30420 AZ Primary
Cardiac Rehabilitation Clinic/Center 261QR0404X 30420 AZ

Addresses

Primary practice location

2000 S Thompson St
Flagstaff, AZ 86001-8759

Mailing address

2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1194988824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S THOMPSON ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860018759",
            "telephone_number": "928-226-6400",
            "fax_number": "928-226-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S THOMPSON ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860018759",
            "telephone_number": "928-226-6400",
            "fax_number": "928-226-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN HEART CATH LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "DUVAL",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "928-226-6400"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "30420",
            "primary": true
        },
        {
            "code": "261QR0404X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Cardiac Facilities",
            "state": "AZ",
            "license": "30420",
            "primary": false
        }
    ],
    "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 Apr 7, 2009; 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.