Seaside Sanctuary Clinic LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

K6250 Issued in TX

Legal business name

SEASIDE SANCTUARY CLINIC LLC

Doing business as

MARY C. MEADOWS, N.D.

Practice address

2401 W Route 66
#24
Flagstaff, AZ 86001-8761

Phone

(361) 463-1353

Fax

(215) 261-0666

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Miss Mary C Meadows, N.D.

Title

Director

Phone

(361) 463-1353

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MARY C. MEADOWS, N.D. Doing business as

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285784082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W ROUTE 66",
            "address_2": "#24",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860018761",
            "telephone_number": "361-463-1353",
            "fax_number": "215-261-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W ROUTE 66",
            "address_2": "#24",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860018761",
            "telephone_number": "361-463-1353",
            "fax_number": "215-261-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE SANCTUARY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEADOWS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "361-463-1353",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "N.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "K6250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0033LT",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARY C. MEADOWS, N.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lita A Scott, FNP
• Randall Perry Scott, MD
• Lindsay Seals
• Leslie D Seaman, D.D.S.
• Leslie Scott Seaman, DDS
• Michelle Sebastian, RBT
• Mark V Seby, M.D.
• Michael Seby, MD
• Sandra Joyce Seby, LAC
• Sedona Psychiatry

• Specialist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Specialist in Arizona

• 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.