Individual provider Active NPI

Rachael Marie Stillwagon, P.A.

  • Allergy & Immunology Physician
  • Scottsdale, AZ
National Provider Identifier
1437174208
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
2626 Issued in AZ
Practice address
10200 N 92ND St Ste 130
Scottsdale, AZ 85258-4535
Phone
(480) 614-8011
Fax
(480) 614-8014
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 2626 AZ Primary

Addresses

Primary practice location

10200 N 92ND St Ste 130
Scottsdale, AZ 85258-4535

Mailing address

7514 E Monterey Way Ste 1
Scottsdale, AZ 85251-6900
Phone (804) 949-7377

Other practice location 1

7514 E Monterey Way Ste 1
Scottsdale, AZ 85251-6900
Phone (480) 949-7377

Other names 1

  • Rachael Marie Carmichael 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
I20140120000701 AZ Practitioner - Physician Assistant 7315175353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allergy, Asthma and Immunology Associates LTDGroup PAC ID 8123003829, 7 clinicians

Practice addresses (Care Compare)

10200 N 92ND St
Suite 130
Scottsdale, AZ 85258-4535
Phone (602) 949-7377

7514 E Monterey Way
Suite 1
Scottsdale, AZ 85251-6900
Phone (480) 949-7377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2626AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Center for Allergy and Chest Diseases PastSince Sep 16, 2018 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1437174208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7514 E MONTEREY WAY STE 1",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516900",
            "telephone_number": "804-949-7377",
            "fax_number": "480-949-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 N 92ND ST STE 130",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584535",
            "telephone_number": "480-614-8011",
            "fax_number": "480-614-8014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7514 E Monterey Way Ste 1",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852516900",
            "country_code": "US",
            "telephone_number": "480-949-7377",
            "fax_number": "480-949-8339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILLWAGON",
        "first_name": "RACHAEL",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "AZ",
            "license": "2626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHAEL",
            "last_name": "CARMICHAEL",
            "middle_name": "MARIE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.