Individual provider Active NPI

Anna M Symond, PA-C, L.AC.

  • Physician Assistant
  • Prescott, AZ
National Provider Identifier
1386762953
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1049 Issued in AZ
Practice address
172 E Merritt St
Prescott, AZ 86301
Phone
(928) 445-0141
Fax
(928) 445-9641
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 0046 AZ
Physician Assistant 363A00000X 1409 AZ
Physician Assistant 363A00000X 1049 AZ Primary

Addresses

Primary practice location

172 E Merritt St
Prescott, AZ 86301

Mailing address

172 E Merritt St Ste a
Prescott, AZ 86301
Phone (928) 445-0141

Other names 1

  • Ms. Ann M Cocilovo Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1409AZMDOptometrist
0046AZMDAthletic Trainer
1049AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1386762953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 E MERRITT ST STE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "928-445-0141",
            "fax_number": "928-445-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 E MERRITT ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86301",
            "telephone_number": "928-445-0141",
            "fax_number": "928-445-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMOND",
        "first_name": "ANNA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C, L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "AZ",
            "license": "0046",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1409",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "COCILOVO",
            "middle_name": "M",
            "prefix": "MS.",
            "credential": "PA-C, L.AC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.