Richard M. Kootman M.D.,P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

19610 Issued in AZ

Legal business name

RICHARD M. KOOTMAN M.D.,P.C.

Practice address

13943 N. 91St Ave BLDG G
Peoria, AZ 85381-3687

Phone

(623) 561-1995

Fax

(623) 561-2446

NPI assigned

Nov 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard M Kootman, M.D.NPI 1700896149

Title

Medical Director

Phone

(623) 561-1995

Specialties & licenses 1

Addresses

Other names 1

• Arrowhead Eye Center Other name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 4

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

• Richard M Kootman, M.D., P.C.

  • Specialist
  • Peoria, AZ
  • NPI 1700896149
  Medicare reassignment NPD Authorized official
• Helen Cobb, FNP

  • Family Nurse Practitioner
  • Wickenburg, AZ
  • NPI 1366561086
  NPD (past)
• Jon S Jacobson, MD

  • Ophthalmology Physician
  • Scottsdale, AZ
  • NPI 1558475681
  NPD (past)
• Clayton Carl Westphal, O.D.

  • Optometrist
  • Glendale, AZ
  • NPI 1760434351
  NPD (past)

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1467634477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13943 N. 91ST AVE BLDG G",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813687",
            "telephone_number": "623-561-1995",
            "fax_number": "623-561-2446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13943 N. 91ST AVE BLDG G",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853813687",
            "telephone_number": "623-561-1995",
            "fax_number": "623-561-2446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD M. KOOTMAN M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "KOOTMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "623-561-1995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "19610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arrowhead Eye Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rhad Academy and Healthcare
• Rhad Health Care
• Rhad Health Care LLC
• Vanessa Gail Rhodes, NP
• Bradley D Rice Jr., M.S. CCC-SLP
• Kaysha Richards, PSY.D.
• Bruce C Richardson, DC
• Nicole Richardson
• Maya Richardswilliams, LMT
• Kristina Richer, LAC

• Specialist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.