Acacia Family Practice Group of Lake Havasu, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ACACIA FAMILY PRACTICE GROUP OF LAKE HAVASU, INC

Practice address

1951 Mesquite Ave Ste H
Lake Havasu City, AZ 86403-5746

Phone

(928) 550-7036

NPI assigned

Jul 12, 2022

Organization subpart

No

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

Authorized official

Name

Silvia Garcia, RN

Title

Owner/Ceo

Phone

(928) 246-4025

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dawn Jannice Domenech, A-GNP-C

  • Family Nurse Practitioner
  • Yuma, AZ
  • NPI 1093171456
  Medicare reassignment NPD
• Julia L Luevanos, FNP

  • Family Nurse Practitioner
  • Yuma, AZ
  • NPI 1669097051
  Medicare reassignment NPD
• Sherri Sue Payne, CRNP

  • Nurse Practitioner
  • Council Bluffs, IA
  • NPI 1891714507

  AZ

  Medicare reassignment NPD

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705536000000",
    "number": "1295469641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 MESQUITE AVE STE H",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035746",
            "telephone_number": "928-550-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 MESQUITE AVE STE H",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035746",
            "telephone_number": "928-550-7036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACACIA FAMILY PRACTICE GROUP OF LAKE HAVASU, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-12",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "SILVIA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "928-246-4025",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• A Natural Massage
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• Thomas H Aamot, D.C.
• Maria Rosalie G Abad
• Kanaan Abow Alkhier, MD, RPVI, RCS, RVS
• Acacia Hospice Care of Lake Havasu Inc
• Acadia, LLC
• Act Mental Health Services, LLC
• Allison Adams, CCC-SLP
• Laura Adams, PHARMD

• General Practice Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.