Individual provider Active NPI

Alan J. Schenne, DO

  • Family Medicine Physician
  • Prescott, AZ
National Provider Identifier
1285696351
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
007190 Issued in AZ
Practice address
1050 Gail Gardner Way Ste 300
Prescott, AZ 86305-1640
Phone
(928) 717-5232
Fax
(928) 717-5238
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3654 IA
Family Medicine Physician 207Q00000X 007190 AZ Primary

Addresses

Primary practice location

1050 Gail Gardner Way Ste 300
Prescott, AZ 86305-1640

Mailing address

PO Box 10080
Prescott, AZ 86304-0880
Phone (928) 759-5987

Other identifiers 3

IdentifierTypeStateIssuer
007190OtherAZARIZONA LICENSE
260247MedicaidAZ
Z202481OtherAZMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170628001079 AZ Practitioner - Family Practice 6002853785 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3654IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen J Harkins DDS PC CurrentSince Sep 1, 2022 Accepting new patients
Mercy Medical Services Family Medicine Past Accepting new patients

Locations

4781 E Camp Lowell Dr
Ste 101
Tucson, AZ 85712
Phone (520) 298-6909

Interoperability endpoints

  • Direct secure messaging: alanschenne@bhcc.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1285696351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10080",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "928-759-5987",
            "fax_number": "928-458-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 GAIL GARDNER WAY STE 300",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051640",
            "telephone_number": "928-717-5232",
            "fax_number": "928-717-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENNE",
        "first_name": "ALAN",
        "middle_name": "J.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "3654",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "007190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA LICENSE",
            "identifier": "007190",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260247",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "Z202481",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.