Untied of Northern Arizona

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

UNTIED OF NORTHERN ARIZONA

Practice address

1672 Oaklawn Dr
Prescott, AZ 86305-1106

Phone

(928) 257-1224

Fax

(928) 264-5299

NPI assigned

Mar 4, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Shelly Klein, MDNPI 1659449411

Title

Owner/ Primary Physician

Phone

(928) 257-1224

Specialties & licenses 1

Addresses

Other names 1

• Untied of Northern Arizona Doing business as

Practitioners 1

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

• Shelly Faye Klein, MD

  • Pediatrics Physician
  • Prescott, AZ
  • NPI 1659449411
  NPD (past) Authorized official

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1487411641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7025 E AUTUMN LN",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863154807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 OAKLAWN DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051106",
            "telephone_number": "928-257-1224",
            "fax_number": "928-264-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1672 Oaklawn Dr",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863051106",
            "country_code": "US",
            "telephone_number": "928-445-5339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UNTIED OF NORTHERN ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER/ PRIMARY PHYSICIAN",
        "authorized_official_telephone_number": "928-257-1224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Untied of Northern Arizona",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Untied of Northern Arizona",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erika Benay Tyler, AGACNP-BC
• Joy L Tyson, CRNP AND CNS-MH
• Erwina Ungos, D.O
• United States Veterans Initiative - Prescott
• Unlimited Home Health Center, Inc
• Robert Claud Upchurch III, N.D.
• Joseph Uridil IV, APRN, AGACNP
• Laura Urquhart, M.S.
• US Dept of Veteran Affairs
• Samantha Painter Usmiller, L.M.T.

• Pediatrics Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; 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.