Individual provider Active NPI

Marvin L Colvin, D.O.

  • Family Medicine Physician
  • Cottonwood, AZ
National Provider Identifier
1336146059
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2771 Issued in AZ
Practice address
753 N Main St
Ste. a
Cottonwood, AZ 86326-3649
Phone
(928) 634-7470
Fax
(928) 639-3280
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DO2771 AZ Primary

Addresses

Primary practice location

753 N Main St
Ste. a
Cottonwood, AZ 86326-3649

Mailing address

753 N Main St
Ste. a
Cottonwood, AZ 86326-3649
Phone (928) 634-7470

Other identifiers 1

IdentifierTypeStateIssuer
111112MedicaidAZ

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
I20100803000046 AZ Practitioner - Family Practice 3577696210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
College of Osteo Med of the Pacific at Pomona, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marvin L Colvin DOGroup PAC ID 8123008034, 2 clinicians

Practice addresses (Care Compare)

753 N Main St
Cottonwood, AZ 86326-3649
Phone (928) 634-7470

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO2771AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marvin L Colvin DO Family Medicine CurrentSince Jul 1, 1966 Accepting new patients
NM Pacs 2 LLC Hospitalist Past Accepting new patients
Family Medical Center Past Accepting new patients

Locations

753 N Main St
Ste A
Cottonwood, AZ 86326
Phone (520) 634-7470

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/57966
  • Direct secure messaging: marvin.colvin@69592637964292.direct.elationemr.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CHCFAD

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1336146059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "address_2": "STE. A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263649",
            "telephone_number": "928-634-7470",
            "fax_number": "928-639-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "address_2": "STE. A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263649",
            "telephone_number": "928-634-7470",
            "fax_number": "928-639-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVIN",
        "first_name": "MARVIN",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "DO2771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111112",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.