Desert Spurs Primary Care, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

48283 Issued in AZ

Legal business name

DESERT SPURS PRIMARY CARE, PLLC

Practice address

1355 Ramar Rd
Ste. 10
Bullhead City, AZ 86442-7100

Phone

(928) 444-8405

Fax

(928) 299-5300

NPI assigned

Aug 17, 2016

Organization subpart

No

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

Authorized official

Name

Robert J Bazaco, M.D.

Title

Owner

Phone

(210) 464-8311

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Kerstin Annette McElvain, CRNP

  • Nurse Practitioner
  • Albertville, AL
  • NPI 1508320706
  NPD
• Barney Bailey Foster, PAC

  • Physician Assistant
  • Bullhead City, AZ
  • NPI 1821026626
  NPD (past)

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1730634965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 MOSER AVE",
            "address_2": "APT. 105",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864295240",
            "telephone_number": "210-464-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 RAMAR RD",
            "address_2": "STE. 10",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427100",
            "telephone_number": "928-444-8405",
            "fax_number": "928-299-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT SPURS PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "BAZACO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-464-8311",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "48283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATION ID#",
            "identifier": "P20970983",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desert Hi Tech Durable Medical LLC (Desert Hi Tech Medical Supply)
• Desert Oasis Medical Center, PLLC
• Desert Palms Medical Associates Inc
• Desert Pulmonology, LTD.
• Desert Springs Urgent Care, PC
• Desert Trails Home Health, LLC
• Benjamin B Dexter, P.A.-C.
• Carol Ann Diehl, PT
• Tuan Dinh
• Leo Richard Dodier III, D.C.

• Family Medicine Physician in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.