Ccent & FPS

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

3000 Issued in AZ

Legal business name

CCENT & FPS

Practice address

300 W White Mountain Blvd
Suite D
Lakeside, AR 85929-6533

Phone

(928) 774-1873

NPI assigned

May 9, 2008

Last updated

May 9, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

CCENT & FPSAs reported in NPPES

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

Authorized official

Name

Dr. Tamarah A Fratianni, D.ONPI 1689673972

Title

Physician

Phone

(928) 774-1873

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Crystal Canyon ENT & Facial Plastic Surgery PC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Flagstaff, AZ
  • NPI 1285780767

  O20040210000400

  Same enrollment

Part of

Ccent FPS

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tamarah Fratianni, D.O

  • Facial Plastic Surgery Physician
  • Flagstaff, AZ
  • NPI 1689673972
  Authorized official Same address or phone

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1467629469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 N RIM DRIVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011311",
            "telephone_number": "928-774-1873",
            "fax_number": "928-774-5525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W WHITE MOUNTAIN BLVD",
            "address_2": "SUITE D",
            "city": "LAKESIDE",
            "state": "AR",
            "postal_code": "859296533",
            "telephone_number": "928-774-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCENT & FPS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CCENT & FPS",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "FRATIANNI",
        "authorized_official_first_name": "TAMARAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "928-774-1873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "AZ",
            "license": "3000",
            "primary": true
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "AZ",
            "license": "3000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.