Organization Active NPI

White Mountain Family Practice Associates LTD

  • Family Medicine Physician
  • Lakeside, AZ
National Provider Identifier
1467580894
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7081 Issued in AZ
Legal business name
WHITE MOUNTAIN FAMILY PRACTICE ASSOCIATES LTD
Practice address
5658 Highway 260
Suite 19
Lakeside, AZ 85929-5189
Phone
(928) 532-5838
Fax
(928) 532-6670
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Authorized official

Name
Linda Neel
Title
Manager
Phone
(928) 532-5838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 7081 AZ Primary

Addresses

Primary practice location

5658 Highway 260
Suite 19
Lakeside, AZ 85929-5189

Mailing address

5658 Highway 260
Suite 19
Lakeside, AZ 85929-5189
Phone (928) 532-5838

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1467580894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5658 HIGHWAY 260",
            "address_2": "SUITE 19",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295189",
            "telephone_number": "928-532-5838",
            "fax_number": "928-532-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5658 HIGHWAY 260",
            "address_2": "SUITE 19",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295189",
            "telephone_number": "928-532-5838",
            "fax_number": "928-532-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MOUNTAIN FAMILY PRACTICE ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "NEEL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "928-532-5838"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "7081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeside, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.