Active NPI
Jeffrey R Lischke Jr.
- Emergency Medicine Physician
- Safford, AZ
National Provider Identifier
1447086988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 10721
- Practice address
- 1600 S 20TH Ave
Safford, AZ 85546-4011 - Phone
- (928) 348-4000
- NPI assigned
- Sep 11, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 10721 | AZ | Primary |
Addresses
Primary practice location
1600 S 20TH Ave
Safford, AZ 85546-4011
Mailing address
1600 S 20TH Ave
Safford, AZ 85546-4011
Phone (928) 348-4000
Other practice location 1
14455 W Van Buren St # 100
Goodyear, AZ 85338-9209
Phone (623) 518-2386
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Safford, AZ
- NPI 1275588345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734652800000",
"number": "1447086988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 S 20TH AVE",
"city": "SAFFORD",
"state": "AZ",
"postal_code": "855464011",
"telephone_number": "928-348-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 S 20TH AVE",
"city": "SAFFORD",
"state": "AZ",
"postal_code": "855464011",
"telephone_number": "928-348-4000"
}
],
"practiceLocations": [
{
"address_1": "14455 W Van Buren St # 100",
"address_purpose": "LOCATION",
"city": "Goodyear",
"state": "AZ",
"postal_code": "853389209",
"country_code": "US",
"telephone_number": "623-518-2386",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LISCHKE",
"first_name": "JEFFREY",
"middle_name": "R",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-09-11",
"last_updated": "2024-12-20",
"certification_date": "2024-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AZ",
"license": "10721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Safford, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.