Individual provider Active NPI

Fernando E Vazquez Rocha, DO

  • Student in an Organized Health Care Education/Training Program
  • Kingman, AZ
National Provider Identifier
1407554876
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
1407554876 Issued in AZ
Practice address
3269 Stockton Hill Rd.
Kingman, AZ 86409-3619
Phone
(928) 263-4466
NPI assigned
Feb 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R4362 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 1407554876 AZ Primary

Addresses

Primary practice location

3269 Stockton Hill Rd.
Kingman, AZ 86409-3619

Mailing address

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 263-4466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R4362AZMDEmergency Medicine Physician
1407554876AZMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1407554876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-263-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3269 STOCKTON HILL RD.",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-263-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ ROCHA",
        "first_name": "FERNANDO",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-15",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R4362",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "1407554876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.