Active NPI
No Ariz Dermatology Center
- Clinical Medical Laboratory
- Cottonwood, AZ
National Provider Identifier
1336284942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- NO ARIZ DERMATOLOGY CENTER
- Practice address
- 297 S Willard St
Cottonwood, AZ 86326 - Phone
- (928) 639-9596
- Fax
- (928) 639-0189
- NPI assigned
- Feb 21, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Cynthia Ackermann Knutson, MD
- Title
- Ceo
- Phone
- (928) 774-5074
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
297 S Willard St
Cottonwood, AZ 86326
Mailing address
1490 N Turquoise Dr
Saa
Flagstaff, AZ 86001
Phone (928) 774-5074
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0301000963 | Other | AZ | CLIA |
National Provider Directory
National Provider Directory- Tax ID family
- No Ariz Dermatology Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Flagstaff, AZ
- NPI 1932244266
Locations
1490 N Turquoise Dr
Flagstaff, AZ 86001
Phone (928) 744-5074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1336284942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1490 N TURQUOISE DR",
"address_2": "SAA",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "86001",
"telephone_number": "928-774-5074",
"fax_number": "928-779-0884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "297 S WILLARD ST",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "86326",
"telephone_number": "928-639-9596",
"fax_number": "928-639-0189"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NO ARIZ DERMATOLOGY CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-21",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "KNUTSON",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_middle_name": "ACKERMANN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "928-774-5074",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "0301000963",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cottonwood, AZ
- Nazcare - Serenity Circle Wellness Center
- Nelson Chiropractic, Inc.
- Thomas V Neumann, MD
- Paula S Newman, PSY.D.
- Tamara Jean Nisly, REGISTERED DIETICIAN
- Northern Arizona Dermatology Center PC
- Northern Arizona Healthcare
- Northern Arizona Healthcare Corporation (Northern Arizona Healthcare Medical Group Sleep- Cottonwood)
- Northern Arizona Healthcare Corporation (Northern Arizona Healthcare Medical Group - Cottonwood)
- Northern Arizona Healthcare Corporation (Northern Arizona Healthcare Medical Group Cardiology-Cottonwood)
Sources for this page
- 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.