Individual provider Active NPI

Colleen Mary McWeeney, FNP

  • Family Nurse Practitioner
  • Kingman, AZ
National Provider Identifier
1366957177
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AZ10792 Issued in AZ
Practice address
1510 N Stockton Hill Rd
Kingman, AZ 86401-5173
Phone
(928) 753-1177
NPI assigned
Dec 4, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AZ10792 AZ Primary

Addresses

Primary practice location

1510 N Stockton Hill Rd
Kingman, AZ 86401-5173

Mailing address

PO Box 3630
Flagstaff, AZ 86003-3630
Phone (928) 522-9879

Other names 1

  • Colleen M McGuire, Martin, Martin-Dowler Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171218003272 AZ Practitioner - Nurse Practitioner 4789942848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ10792AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. CurrentSince Nov 17, 2017 Accepting new patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Nov 17, 2017 Accepting new patients
North Country Healthcare Inc Past Accepting new patients

Locations

2585 Miracle Mile
Ste 116
Bullhead City, AZ 86442
Phone (928) 704-1221

2187 N Vickey St
Ste 2
Flagstaff, AZ 86004
Phone (928) 527-1899

2920 N 4th St
Flagstaff, AZ 86004
Phone (928) 213-6100

1501 S Yale St
Ste 252
Flagstaff, AZ 86001
Phone (928) 774-1811

1120 W University Ave
Flagstaff, AZ 86001
Phone (928) 522-1300

2500 N Rose St
Flagstaff, AZ 86004
Phone (928) 213-6121

2109 Navajo Blvd
Holbrook, AZ 86025
Phone (928) 213-6100

1510 N Stockton Hill Rd
Kingman, AZ 86401
Phone (928) 753-1177

3505 Western Ave
Ste B
Kingman, AZ 86409
Phone (928) 692-0849

2090 Smoketree Ave N
Lk Havasu Cty, AZ 86403
Phone (928) 854-1800

126 E Main St
Ste B
Payson, AZ 85541
Phone (928) 472-3700

2650 E Show Low Lake Rd
Ste 1
Show Low, AZ 85901
Phone (928) 537-4300

488 S Mountain Ave
Springerville, AZ 85938
Phone (928) 333-0127

300 S 6th St
Williams, AZ 86046
Phone (928) 635-4441

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1366957177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630",
            "telephone_number": "928-522-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864015173",
            "telephone_number": "928-753-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWEENEY",
        "first_name": "COLLEEN",
        "middle_name": "MARY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AZ10792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "MCGUIRE, MARTIN, MARTIN-DOWLER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.