Active NPI
Edgar Jay Pringle, MD
- Diagnostic Radiology Physician
- Show Low, AZ
National Provider Identifier
1700866696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 12528
- Practice address
- 2200 E Show Low Lake Rd
Show Low, AZ 85901-7881 - Phone
- (928) 537-6338
- Fax
- (928) 532-5947
- NPI assigned
- Jan 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 12528 | AZ | Primary |
Addresses
Primary practice location
2200 E Show Low Lake Rd
Show Low, AZ 85901-7881
Mailing address
PO Box 548
Cottonwood, AZ 86326-0548
Phone (928) 634-0665
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 253724 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12528 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194393600000",
"number": "1700866696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 548",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863260548",
"telephone_number": "928-634-0665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 E SHOW LOW LAKE RD",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859017881",
"telephone_number": "928-537-6338",
"fax_number": "928-532-5947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRINGLE",
"first_name": "EDGAR",
"middle_name": "JAY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2007-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AZ",
"license": "12528",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "253724",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.