NPIMap

Organization Active NPI

Neal W Mogk MD PC.

  • Family Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1225200751
Registry record updated Jan 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
AZ17321 Issued in AZ
Legal business name
NEAL W MOGK MD PC.
Practice address
715 N Beaver St
Flagstaff, AZ 86001-3141
Phone
(928) 774-7345
Fax
(928) 774-4622
NPI assigned
Mar 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2009

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

Authorized official

Name
Dr. Neal W Mogk
Title
Owner/ Doctor
Phone
(928) 774-7345

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X AZ17321 AZ Primary

Addresses

Primary practice location

715 N Beaver St
Flagstaff, AZ 86001-3141

Mailing address

715 N Beaver St
Flagstaff, AZ 86001-3141
Phone (928) 774-7345

Other identifiers 2

IdentifierTypeStateIssuer
AZ0848210OtherAZBCBS
277477MedicaidAZ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231459200000",
    "number": "1225200751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013141",
            "telephone_number": "928-774-7345",
            "fax_number": "928-774-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013141",
            "telephone_number": "928-774-7345",
            "fax_number": "928-774-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAL W MOGK MD PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2009-01-09",
        "status": "A",
        "authorized_official_last_name": "MOGK",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/ DOCTOR",
        "authorized_official_telephone_number": "928-774-7345",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "AZ17321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0848210",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277477",
            "state": "AZ"
        }
    ],
    "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 Jan 9, 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.