NPIMap

Organization Active NPI

Colonna Physician Services LLC

  • Emergency Medicine Physician
  • Kingman, AZ
National Provider Identifier
1346708708
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
COLONNA PHYSICIAN SERVICES LLC
Practice address
4030 N Stockton Hill Rd Ste 3
Kingman, AZ 86409-2452
Phone
(928) 897-5365
Fax
(928) 443-8941
NPI assigned
Mar 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Authorized official

Name
Michael Colonna, DO
Title
Owner
Phone
(928) 897-5365

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

4030 N Stockton Hill Rd Ste 3
Kingman, AZ 86409-2452

Mailing address

4030 N Stockton Hill Rd Ste 3
Kingman, AZ 86409-2452
Phone (928) 897-5365

Other names 1

  • Michael Colonna Doing business as

National Provider Directory

National Provider Directory

Locations

4030 N Stockton Hill Rd
Ste 3
Kingman, AZ 86409
Phone (928) 897-5365

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576108800000",
    "number": "1346708708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 N STOCKTON HILL RD STE 3",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864092452",
            "telephone_number": "928-897-5365",
            "fax_number": "928-443-8941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 N STOCKTON HILL RD STE 3",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864092452",
            "telephone_number": "928-897-5365",
            "fax_number": "928-443-8941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONNA PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A",
        "authorized_official_last_name": "COLONNA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-897-5365",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael Colonna",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Michael Colonna",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.