Foothills Walkin Medical

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

3278 Issued in AZ

Legal business name

FOOTHILLS WALKIN MEDICAL

Practice address

11274 S Fortuna Rd
Suite I-4
Yuma, AZ 85367-7847

Phone

(928) 345-2150

Fax

(928) 345-2151

NPI assigned

May 1, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Ana Cecilia Gonzalez, PA-C

Title

PA-C

Phone

(928) 345-2150

Specialties & licenses 1

Addresses

Other names 1

• LEVEL 4 INC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Smock, MD

  • Family Medicine Physician
  • Yuma, AZ
  • NPI 1710980206
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730309717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11274 S FORTUNA RD",
            "address_2": "SUITE I-4",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853677847",
            "telephone_number": "928-345-2150",
            "fax_number": "928-345-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11274 S FORTUNA RD",
            "address_2": "SUITE I-4",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853677847",
            "telephone_number": "928-345-2150",
            "fax_number": "928-345-2151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS WALKIN MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "CECILIA",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "928-345-2150",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "AZ",
            "license": "3278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LEVEL 4 INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gabriel A Fonseca, PT
• Foothills Adult Care Home
• Foothills Adult Care Home
• Foothills Blvd Clinic LLC
• Foothills Shoes LLC
• Patrick Craig Ford, PHYSICIAN ASSISTANT
• Kendra Lashon Foreman, APRN
• Form Physical Therapy & Rehabilitation PLLC
• David Wayne Fornof Jr., PARAMEDIC
• Richard Fortney, P.A

• Legal Medicine in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Legal Medicine in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.