NPIMap

Organization Active NPI

Marvin L Colvin DO

  • Family Medicine Physician
  • Cottonwood, AZ
National Provider Identifier
1659553139
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO2771 Issued in AZ
Legal business name
MARVIN L COLVIN DO
Practice address
753 N Main St
Ste a
Cottonwood, AZ 86326-3649
Phone
(928) 634-7470
Fax
(928) 639-3280
NPI assigned
Nov 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Marvin L Colvin, D.O.NPI 1336146059
Title
Owner
Phone
(928) 634-7470

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X DO2771 AZ Primary
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X AP0586 AZ
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X FNP361 AZ

Addresses

Primary practice location

753 N Main St
Ste a
Cottonwood, AZ 86326-3649

Mailing address

753 N Main St
Ste a
Cottonwood, AZ 86326-3649
Phone (928) 634-7470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721001621 AZ Part B Supplier - Clinic/Group Practice 8123008034 Receives reassigned benefits from 2 practitioners
Practice locations: Cottonwood, AZ

National Provider Directory

National Provider Directory

Locations

753 N Main St
Ste A
Cottonwood, AZ 86326
Phone (520) 634-7470

Practitioners & affiliated clinicians

Practitioners 5

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": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1659553139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "address_2": "STE A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263649",
            "telephone_number": "928-634-7470",
            "fax_number": "928-639-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "address_2": "STE A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263649",
            "telephone_number": "928-634-7470",
            "fax_number": "928-639-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN L COLVIN DO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "COLVIN",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-634-7470",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "DO2771",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP0586",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "FNP361",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.