Individual provider Active NPI

Ann Brown McCombs, D.O.

  • Integrative Medicine Physician
  • Prescott, AZ
National Provider Identifier
1407029903
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Integrative Medicine PhysicianTaxonomy code 202D00000X
License
OP00001238 Issued in WA
Practice address
144 Lakeside St
Prescott, AZ 86305-5010
Phone
(206) 718-4343
Fax
(928) 237-3245
NPI assigned
Apr 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP00001238 WA
General Practice Physician 208D00000X OP00001238 WA
Integrative Medicine Physician 202D00000X OP00001238 WA Primary

Addresses

Primary practice location

144 Lakeside St
Prescott, AZ 86305-5010

Mailing address

144 Lakeside St
Prescott, AZ 86305-5010
Phone (206) 718-4343

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180608002297 AZ Practitioner - Osteopathic Manipulative Medicine 5193070423 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Preventive Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital AssociationGroup PAC ID 0244134682, shared by 9 NPIs, 39 clinicians

Practice addresses (Care Compare)

1454 N Co Rd 2050
Carthage, IL 62321-0160

1454 N County Rd
Carthage, IL 62321-0160
Phone (217) 357-8500

PO Box
Carthage, IL 62321-0160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP00001238WAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tucson Physician Group Holdings, LLC CurrentSince Sep 4, 2018 Accepting new patients
Raghav LLC CurrentSince Feb 5, 2025 Accepting new patients
The Center for Optimal Health Past Accepting new patients

Locations

2286 Crosswind Dr
Ste C
Prescott, AZ 86301
Phone (623) 227-1000

15920 S Rancho Sahuarita Blvd
Ste 120
Sahuarita, AZ 85629
Phone (520) 575-1175

12361 W Bola Dr
Ste 109
Surprise, AZ 85378
Phone (623) 227-1000

395 N Silverbell Rd
Ste 355
Tucson, AZ 85745
Phone (520) 622-5912

1001 E Hebron Pkwy
Ste 118347
Carrollton, TX 75010

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/MmWbh382tKlbvAIA1_DeLlIjYVSwroch/

Organizations & group practices 3

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": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1407029903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 LAKESIDE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863055010",
            "telephone_number": "206-718-4343",
            "fax_number": "928-237-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 LAKESIDE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863055010",
            "telephone_number": "206-718-4343",
            "fax_number": "928-237-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOMBS",
        "first_name": "ANN",
        "middle_name": "BROWN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001238",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "OP00001238",
            "primary": false
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "WA",
            "license": "OP00001238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.