Organization Active NPI

Mary E. Moyer MD PLLC

  • Family Medicine Physician
  • Prescott Valley, AZ
National Provider Identifier
1245324003
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19675 Issued in AZ
Legal business name
MARY E. MOYER MD PLLC
Practice address
3251 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone
(928) 772-2582
Fax
(928) 772-2383
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John C Moyer
Title
Chief Financial Officer
Phone
(928) 778-1251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 19675 AZ Primary

Addresses

Primary practice location

3251 N Windsong Dr
Prescott Valley, AZ 86314-1222

Mailing address

47 N French Dr
Prescott, AZ 86303-6247
Phone (928) 778-1251

Other identifiers 1

IdentifierTypeStateIssuer
AZ0325351OtherAZNEW BCBS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245324003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N FRENCH DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863036247",
            "telephone_number": "928-778-1251",
            "fax_number": "928-778-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141222",
            "telephone_number": "928-772-2582",
            "fax_number": "928-772-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY E. MOYER MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOYER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "928-778-1251",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "19675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW BCBS",
            "identifier": "AZ0325351",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.