NPIMap

Organization Active NPI

Philip a St Raymond MD PLLC

  • Urology Physician
  • Lake Havasu City, AZ
National Provider Identifier
1629370580
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
14335 Issued in AZ
Legal business name
PHILIP A ST RAYMOND MD PLLC
Practice address
1972 Mesquite Ave
Lake Havasu City, AZ 86403-5729
Phone
(928) 854-6500
Fax
(928) 854-6206
NPI assigned
Nov 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Authorized official

Name
Philip A St Raymond, MDNPI 1609971076
Title
Owner
Phone
(928) 854-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 14335 AZ Primary

Addresses

Primary practice location

1972 Mesquite Ave
Lake Havasu City, AZ 86403-5729

Mailing address

PO Box 1710
Lake Havasu City, AZ 86405-1710
Phone (928) 854-6500

National Provider Directory

National Provider Directory

Locations

1720 Mesquite Ave
Ste 100B
Lake Havasu City, AZ 86403
Phone (928) 453-1800

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1629370580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1710",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864051710",
            "telephone_number": "928-854-6500",
            "fax_number": "928-854-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1972 MESQUITE AVE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035729",
            "telephone_number": "928-854-6500",
            "fax_number": "928-854-6206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP A ST RAYMOND MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "ST RAYMOND",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-854-6500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "AZ",
            "license": "14335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.