NPIMap

Organization Active NPI

Paragon Healthcare of Arizona,LLC.

  • Cardiopulmonary Physical Therapist
  • Bullhead City, AZ
National Provider Identifier
1477786226
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiopulmonary Physical TherapistTaxonomy code 2251C2600X
Legal business name
PARAGON HEALTHCARE OF ARIZONA,LLC.
Practice address
2585 S Miracle Mile
Suite 107
Bullhead City, AZ 86442-7522
Phone
(928) 444-8168
Fax
(928) 444-8169
NPI assigned
Aug 27, 2009
Last updated
Nov 3, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Sam W Spear
Title
Executive Director
Phone
(924) 444-8168

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X NU
Cardiopulmonary Physical Therapist 2251C2600X NU Primary

Addresses

Primary practice location

2585 S Miracle Mile
Suite 107
Bullhead City, AZ 86442-7522

Mailing address

2585 Miracle Mile
Suite 107
Bullhead City, AZ 86442-7522
Phone (928) 444-8168

Other identifiers 1

IdentifierTypeStateIssuer
Z141280OtherAZMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

2585 Miracle Mile
Ste 107
Bullhead City, AZ 86442
Phone (928) 444-8168

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1477786226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 MIRACLE MILE",
            "address_2": "SUITE 107",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427522",
            "telephone_number": "928-444-8168",
            "fax_number": "928-444-8169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 S MIRACLE MILE",
            "address_2": "SUITE 107",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427522",
            "telephone_number": "928-444-8168",
            "fax_number": "928-444-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARAGON HEALTHCARE OF ARIZONA,LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "SPEAR",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "924-444-8168"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251C2600X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Cardiopulmonary",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "Z141280",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.