Northern Arizona Medical Group, PLLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

32218 Issued in AZ

Legal business name

NORTHERN ARIZONA MEDICAL GROUP, PLLC

Practice address

3555 Western Ave
Kingman, AZ 86409-3011

Phone

(928) 757-8440

Fax

(928) 757-5460

NPI assigned

Jul 14, 2015

Organization subpart

Yes

Parent organization

NORTHERN ARIZONA MEDICAL GROUP PLLCAs reported in NPPES

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

Authorized official

Name

Bobbi Neubarth

Title

Office Manager

Phone

(928) 757-8440

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Northern Arizona Medical Group PLLC Doing business as
• Northern Arizona Medical Group Urgent Care Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Northern Arizona Medical Group, PLLC

  • Specialist
  • Kingman, AZ
  • NPI 1770743965

  O20080826000781

  Same enrollment

Part of

Northern Arizona MG PLLC

Practitioners 1

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

• Stacey Lee Meier, FNP-C

  • Family Nurse Practitioner
  • Kingman, AZ
  • NPI 1548031263
  NPD

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1699159111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3555 WESTERN AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093011",
            "telephone_number": "928-757-8440",
            "fax_number": "928-757-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 WESTERN AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093011",
            "telephone_number": "928-757-8440",
            "fax_number": "928-757-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ARIZONA MEDICAL GROUP, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHERN ARIZONA MEDICAL GROUP PLLC",
        "enumeration_date": "2015-07-14",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "NEUBARTH",
        "authorized_official_first_name": "BOBBI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-757-8440"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AZ",
            "license": "32218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357676",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Arizona Medical Group PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northern Arizona Medical Group PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northern Arizona Medical Group Urgent Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Northern Arizona Medical Group, PLLC
• Northern Arizona Medical Group, PLLC
• Northern Arizona Physical Therapy Associates
• Charles R Norwood, PHARMD
• Erin Novak, PA-C
• Sarah Novak, CCC-SLP

• Urgent Care Clinic/Center in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Urgent Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.