Active NPI
Alan J. Schenne, DO
- Family Medicine Physician
- Prescott, AZ
National Provider Identifier
1285696351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 007190
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007190 | Other | AZ | ARIZONA LICENSE |
| 260247 | Medicaid | AZ | |
| Z202481 | Other | AZ | MEDICARE |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3654 | IA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen J Harkins DDS PC | Current | 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
- 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.
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- NPI 1043251754
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.