Heart Shop, LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

HEART SHOP, LLC

Practice address

242 Whipple St
Prescott, AZ 86301-1787

Phone

(928) 708-9355

Fax

(928) 778-0278

NPI assigned

Mar 19, 2020

Last updated

May 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Wayne Rothrock, MDNPI 1265472138

Title

Owner

Phone

(928) 708-9355

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

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.

• Douglas Wayne Rothrock, M.D.

  • Specialist
  • Prescott, AZ
  • NPI 1265472138

  Cardiovascular Disease

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1558997742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 WHIPPLE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011787",
            "telephone_number": "928-708-9355",
            "fax_number": "928-778-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 WHIPPLE ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011787",
            "telephone_number": "928-708-9355",
            "fax_number": "928-778-0278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART SHOP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-19",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "ROTHROCK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-708-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nancy@theheartshopaz.com",
            "affiliation": "N",
            "endpointDescription": "Hippa Email",
            "address_1": "242 Whipple St",
            "city": "Prescott",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863011787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jared Head, ACNP
• Healing Kind Health and Wellness
• Health Walk Medical Clinic, PLLC
• Stephanie Lynn Hearl, LMT
• Stephanie Hearn, MS, CCC-SLP
• Gary Hees, LPC
• Herman Charles Heikkenen, MD
• Thomas Jeffrey Hein, LPC
• Arthur Lynn Heitzman, PH.D.
• Helen Paslay Professional Nurse Practitioner Services PLLC

• Cardiovascular Disease Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Cardiovascular Disease Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.