Flagstaff Internal Medicine PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

33977 Issued in AZ

Legal business name

FLAGSTAFF INTERNAL MEDICINE PC

Practice address

710 N Beaver St
Building 6
Flagstaff, AZ 86001-3100

Phone

(928) 779-2497

Fax

(928) 226-1068

NPI assigned

Aug 23, 2006

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

Emmalee Nicole Kennedy, MD

Title

Owner

Phone

(928) 779-2497

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760598353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N BEAVER ST",
            "address_2": "BUILDING 6",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013100",
            "telephone_number": "928-779-2497",
            "fax_number": "928-226-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N BEAVER ST",
            "address_2": "BUILDING 6",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013100",
            "telephone_number": "928-779-2497",
            "fax_number": "928-226-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSTAFF INTERNAL MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "EMMALEE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-779-2497",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "33977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flagstaff Family Physicians PC (Optum Primary Care)
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• Flagstaff Integrated Therapies LLC
• Flagstaff Intensive Care Specialists, PLLC
• Flagstaff Medical Center (Guardian Air)
• Flagstaff Medical Center (Guardian Medical Transport)
• Flagstaff Medical Center (Flagstaff Pharmacy)
• Flagstaff Medical Center (FMC Behavioral Health Services)
• Flagstaff Medical Center

• Internal Medicine Physician in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Internal Medicine Physician 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.