Active NPI
Francis S Gagliardi, MD
- Psychiatry Physician
- Cottonwood, AZ
National Provider Identifier
1366423238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 23602
- Practice address
- 269 S Candy LN
Cottonwood, AZ 86326-4158 - Phone
- (928) 639-6450
- Fax
- (928) 639-6456
- NPI assigned
- Nov 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 23602 | AZ | Primary |
| Psychiatry Physician | 2084P0800X | G71143 | CA |
Addresses
Primary practice location
269 S Candy LN
Cottonwood, AZ 86326-4158
Mailing address
1200 N Beaver St
Payer Credentialing
Flagstaff, AZ 86001-3118
Phone (928) 773-2559
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 429086 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G71143 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Miller, MD, PC | Current | Accepting new patients | |
| Flagstaff Pathology Associates | Current | Accepting new patients |
Locations
269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251
1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235
Organizations & group practices 2
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Flagstaff, AZ
- NPI 1306205612
-
- Anatomic Pathology & Clinical Pathology Physician
- Flagstaff, AZ
- NPI 1447459367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458691200000",
"number": "1366423238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 N BEAVER ST",
"address_2": "PAYER CREDENTIALING",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013118",
"telephone_number": "928-773-2559",
"fax_number": "928-213-6292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "269 S CANDY LN",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863264158",
"telephone_number": "928-639-6450",
"fax_number": "928-639-6456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAGLIARDI",
"first_name": "FRANCIS",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-08",
"last_updated": "2016-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "23602",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G71143",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "429086",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cottonwood, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.