Organization Active NPI

Sierra Vista Internal Medicine PLLC

  • Family Medicine Physician
  • Sierra Vista, AZ
National Provider Identifier
1689612293
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
23368 Issued in AZ
Legal business name
SIERRA VISTA INTERNAL MEDICINE PLLC
Practice address
75 Colonia de Salud
Suite 200a
Sierra Vista, AZ 85635
Phone
(520) 458-8145
Fax
(877) 771-1056
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Authorized official

Name
Dr. David J Krapp, MD
Title
Owner
Phone
(520) 458-8145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 23368 AZ Primary

Addresses

Primary practice location

75 Colonia de Salud
Suite 200a
Sierra Vista, AZ 85635

Mailing address

75 Colonia de Salud
Suite 200a
Sierra Vista, AZ 85635
Phone (520) 458-8145

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050331001078 AZ Part B Supplier - Clinic/Group Practice 1052367281 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sierra Vista, AZ

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

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": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1689612293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 COLONIA DE SALUD",
            "address_2": "SUITE 200A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "85635",
            "telephone_number": "520-458-8145",
            "fax_number": "877-771-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 COLONIA DE SALUD",
            "address_2": "SUITE 200A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "85635",
            "telephone_number": "520-458-8145",
            "fax_number": "877-771-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA VISTA INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "KRAPP",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "520-458-8145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "23368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.