Arizona Em-I Medical Services, P.C.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

ARIZONA EM-I MEDICAL SERVICES, P.C.

Practice address

101 Civic Center LN
Lake Havasu City, AZ 86403-5607

Phone

(928) 453-0150

NPI assigned

May 8, 2006

Last updated

Jan 28, 2010By 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

Donald T Godbold, MD

Title

President

Phone

(805) 563-3011

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Arizona Em-I Medical Services

  • Nurse Practitioner
  • Douglas, AZ
  • NPI 1891070520

  O20040421000835

  Same enrollment
• Arizona Em-I Medical Services

  • Physician Assistant
  • Bullhead City, AZ
  • NPI 1891951778

  O20040421000835

  Same enrollment
• Arizona Em-I Medical Services PC

  • Physician Assistant
  • Yuma, AZ
  • NPI 1144768862

  O20040421000835

  Same enrollment
• Arizona Em-I Medical Services, P.C.

  • Emergency Medicine Physician
  • Cottonwood, AZ
  • NPI 1407805658

  O20040421000835

  Same enrollment
• Arizona Em-I Medical Services, PA

  • Nurse Practitioner
  • Winslow, AZ
  • NPI 1518294008

  O20040421000835

  Same enrollment

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1619926532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 STATE ST",
            "address_2": "SUITE 300",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931055602",
            "telephone_number": "805-563-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CIVIC CENTER LN",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035607",
            "telephone_number": "928-453-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA EM-I MEDICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "GODBOLD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-563-3011",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "DF3653",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Arizona Emergency Medicine Specialists PC
• Arizona Express Transportation, LLC
• Arizona Family Medicine PC
• Arizona Heart Institute Lake Havasu
• Arizona in-Home Partner-I, LLC (Havasu Regional Medical Center Home Health)

• Emergency Medicine Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; 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.