Ronald Dale Parker, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

36577 Issued in AZ

Practice address

1713 S Kofa Ave
Suite a
Parker, AZ 85344-6477

Phone

(928) 669-9700

Fax

(928) 669-9104

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• La Paz Regional Hospital, Inc.

  dba Bouse Medical Clinic

  • Clinic/Center
  • Bouse, AZ
  • NPI 1235154147

  Corporate Director

  CMS ownership
• Mohave Healthcare, Inc.

  dba River Valley Hospice

  • Community Based Hospice Care Agency
  • Parker, AZ
  • NPI 1568828804

  Contracted Managing Employee

  CMS ownership

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

• Parker Family Practice PLLC

  • Family Medicine Physician
  • Parker, AZ
  • NPI 1487880712
  Authorized official Same address or phone
• London Bridge Emergency Physicians

  • Emergency Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1962451112
  NPD (past)
• The Arizona Partnership for Immunization

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1942532189
  NPD (past)
• Premise Health of Nevada Medical Hinitt PC

  dba Premise Health Wellness Center-Las Vegas

  • Multi-Specialty Clinic/Center
  • Las Vegas, NV
  • NPI 1649977067
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1285798405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 S KOFA AVE",
            "address_2": "SUITE A",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446477",
            "telephone_number": "928-669-9700",
            "fax_number": "928-669-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 S KOFA AVE",
            "address_2": "SUITE A",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446477",
            "telephone_number": "928-669-9700",
            "fax_number": "928-669-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "RONALD",
        "middle_name": "DALE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "36577",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "11353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parker Medical Center, LTD
• Parker Medical Center, LTD.
• Parker Optical
• Parker Professional Services Group LLC
• Parker Unified School District
• Sandhya Patel
• Astrid Peck, RN
• Andrea Carol Pena, R.T. (R)
• Linda H Perry, RN
• Donald Clinton Peters

• Family Medicine Physician in Parker, AZ
• Providers in Parker, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.