Kokopelli Eye Care PC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

26357 Issued in AZ

Legal business name

KOKOPELLI EYE CARE PC

Practice address

16605 E Palisades Blvd Ste 152
Fountain Hills, AZ 85268-3717

Phone

(844) 565-6393

Fax

(844) 329-5656

NPI assigned

Mar 12, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Michael Lee Ham, MD

Title

President

Phone

(928) 775-5606

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kokopelli Eye Institute Doing business as

Locations

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567641600000",
    "number": "1669975157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 N GLASSFORD HILL RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141242",
            "telephone_number": "928-771-9000",
            "fax_number": "928-759-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16605 E PALISADES BLVD STE 152",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683717",
            "telephone_number": "844-565-6393",
            "fax_number": "844-329-5656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16425 E Palisades Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fountain Hills",
            "state": "AZ",
            "postal_code": "852683754",
            "country_code": "US",
            "telephone_number": "844-565-6393",
            "fax_number": "844-329-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KOKOPELLI EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2019-09-05",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-775-5606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "26357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030341",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kokopelli Eye Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Callie Rowe Kittredge, COTA/L
• John Kline, DPT
• Paul Knott, PHARMD
• Molly Knutson
• Austin Kocchi, DPT
• Alexander Komerdelj
• Allyn Louise Krieger-Fiedler, ND
• Jolene Kring, MS
• Matthew Wade Krug, SLP-CCC
• Jamie May Kuettel, PT, DPT

• Durable Medical Equipment & Medical Supplies in Fountain Hills, AZ
• Providers in Fountain Hills, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.