NPIMap

Organization Active NPI

Kokopelli Eye Care PC

  • Specialist
  • Prescott Valley, AZ
National Provider Identifier
1528005444
Registry record updated Jul 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
26357 Issued in AZ
Legal business name
KOKOPELLI EYE CARE PC
Practice address
2820 N Glassford Hill Rd
Suite 101
Prescott Valley, AZ 86314-1242
Phone
(928) 775-5606
Fax
(928) 772-4999
NPI assigned
May 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2012

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

Authorized official

Name
Dr. Michael Lee Ham, M.D.
Title
President
Phone
(928) 775-5606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 26357 AZ Primary

Addresses

Primary practice location

2820 N Glassford Hill Rd
Suite 101
Prescott Valley, AZ 86314-1242

Mailing address

2820 N Glassford Hill Rd
Suite 101
Prescott Valley, AZ 86314-1242
Phone (928) 775-5606

National Provider Directory

National Provider Directory

Locations

412 Whipple St
Prescott, AZ 86301
Phone (480) 630-8103

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342396800000",
    "number": "1528005444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "address_2": "SUITE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141242",
            "telephone_number": "928-775-5606",
            "fax_number": "928-772-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "address_2": "SUITE 101",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141242",
            "telephone_number": "928-775-5606",
            "fax_number": "928-772-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOKOPELLI EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2012-07-16",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-775-5606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "26357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; 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.