Active NPI
Rodolphe Taby, M.D.
- Family Medicine Physician
- Lake Havasu City, AZ
National Provider Identifier
1710271697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 59752
- Practice address
- 101 Civic Center LN
Lake Havasu City, AZ 86403-5683 - Phone
- (928) 855-8185
- NPI assigned
- Jun 8, 2011
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9527A | WY | |
| Family Medicine Physician | 207Q00000X | 80985 | GA | |
| Hospitalist Physician | 208M00000X | 80985 | GA | |
| Hospitalist Physician | 208M00000X | 9527A | WY | |
| Family Medicine Physician | 207Q00000X | 59752 | AZ | Primary |
Addresses
Primary practice location
101 Civic Center LN
Lake Havasu City, AZ 86403-5683
Mailing address
12603 N Fallen Shadows Dr
Marana, AZ 85658-4497
Phone (832) 885-3499
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 |
|---|---|---|---|
| 80985 | GA | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Hospitalist Services of Arizona LLC | Hospitalist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Hospitalist Physician
- Mesa, AZ
- NPI 1689909780
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614297600000",
"number": "1710271697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12603 N FALLEN SHADOWS DR",
"city": "MARANA",
"state": "AZ",
"postal_code": "856584497",
"telephone_number": "832-885-3499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 CIVIC CENTER LN",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "864035683",
"telephone_number": "928-855-8185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABY",
"first_name": "RODOLPHE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-08",
"last_updated": "2021-02-26",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WY",
"license": "9527A",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "80985",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "GA",
"license": "80985",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WY",
"license": "9527A",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "59752",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Havasu City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.