Flagstaff Medical Center

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y002531 Issued in AZ

Legal business name

FLAGSTAFF MEDICAL CENTER

Practice address

77 W Forest Ave
Ste 104
Flagstaff, AZ 86001-1479

Phone

(928) 773-2565

Fax

(928) 214-3899

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Robert Cofield, RPH

Title

Chief Operating Officer

Phone

(928) 773-2010

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• FLAGSTAFF PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Flagstaff Medical Center

  • Psychiatric Hospital Unit
  • Flagstaff, AZ
  • NPI 1649370875

  2769392554

  Same PAC ID
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078

  2769392554

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

FMC Trauma Billing4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Flagstaff Medical Center

  • Air Ambulance
  • Flagstaff, AZ
  • NPI 1427234111
  NPD tax ID
• Flagstaff Medical Center

  • Land Ambulance
  • Flagstaff, AZ
  • NPI 1518143205
  NPD tax ID
• Flagstaff Medical Center

  • General Acute Care Hospital
  • Flagstaff, AZ
  • NPI 1780635078
  NPD tax ID

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

• Alliance Medical Laboratory, LLC

  • Clinical Medical Laboratory
  • Flagstaff, AZ
  • NPI 1841290806

  Member Of

  NPD member
• Ambulatory Surgi-Center at FMC LLC

  • Ambulatory Surgical Clinic/Center
  • Flagstaff, AZ
  • NPI 1154378909

  Member Of

  NPD member

Locations

Practitioners 38

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

• Bianca Maria Anderson, MS, RD

  • Registered Dietitian
  • Flagstaff, AZ
  • NPI 1548609431
  NPD
• Andrew D Atiemo, M.D.

  • Interventional Cardiology Physician
  • Flagstaff, AZ
  • NPI 1285678748
  NPD
• Lynette Barnhart, NNP-BC

  • Neonatal Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1942678040
  NPD
• Susan Beaupre, RN

  • Critical Care Neonatal Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1598912289
  NPD
• Kenneth John Bescak, MD

  • Cardiovascular Disease Physician
  • Cottonwood, AZ
  • NPI 1164401592
  NPD
• Samuel M Butman, MD

  • Interventional Cardiology Physician
  • Cottonwood, AZ
  • NPI 1982616884
  NPD
• Renzo M Cataldo, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Flagstaff, AZ
  • NPI 1174526677
  NPD
• Heather Daryl Crittenden, MD

  • Internal Medicine Physician
  • Flagstaff, AZ
  • NPI 1467448142
  NPD
• Craig Allen Davis, LCSW

  • Clinical Social Worker
  • Flagstaff, AZ
  • NPI 1225278930
  NPD
• George Destefano, RN

  • Critical Care Neonatal Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1235386913
  NPD
• Karen Duran, NNP

  • Critical Care Neonatal Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1336396019
  NPD
• Jessie Strength Gould, ACNPC-AG

  • Acute Care Nurse Practitioner
  • Flagstaff, AZ
  • NPI 1710679931
  NPD

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1649348442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE",
            "address_2": "STE 104",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011479",
            "telephone_number": "928-773-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE",
            "address_2": "STE 104",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011479",
            "telephone_number": "928-773-2565",
            "fax_number": "928-214-3899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSTAFF MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "COFIELD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "928-773-2010",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y002531",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192104",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1988959",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLAGSTAFF PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Flagstaff Integrated Therapies LLC
• Flagstaff Intensive Care Specialists, PLLC
• Flagstaff Internal Medicine PC
• Flagstaff Medical Center
• Flagstaff Medical Center
• Flagstaff Medical Center
• Flagstaff Medical Center
• Flagstaff Modern Dentistry
• Flagstaff Neurosurgery PLLC
• Flagstaff OBGYN LLC

• Community/Retail Pharmacy in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.