Village of Oak Creek Medical Clinic LLC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

23452 Issued in AZ

Legal business name

VILLAGE OF OAK CREEK MEDICAL CLINIC LLC

Practice address

6486 Hwy 179
Ste 107
Sedona, AZ 86351-7993

Phone

(928) 284-3236

Fax

(928) 284-2531

NPI assigned

Mar 19, 2009

Organization subpart

No

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

Authorized official

Name

Barry D Zaretzky, MD

Title

Owner

Phone

(928) 284-3236

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Linda M Haggard, PAC

  • Medical Physician Assistant
  • Cottonwood, AZ
  • NPI 1871508655
  NPD (past)

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1760623870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1936",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863261936",
            "telephone_number": "928-634-0665",
            "fax_number": "928-634-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6486 HWY 179",
            "address_2": "STE 107",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863517993",
            "telephone_number": "928-284-3236",
            "fax_number": "928-284-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF OAK CREEK MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "ZARETZKY",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-284-3236",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "23452",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AZ",
            "license": "23452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357287",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Verde Valley Medical Center
• Jan Viafora, D.C.
• Chilali Danit Vian, RDMS, RVT
• Vida Transportation, LLC
• Village Clinic LLC
• Kimberly M. Wachter, DDS
• Walgreen Co
• Heather Lee Walker, PHD
• Madison Leigh Walker, ATC
• Kathryn Wallskog, DC

• Gastroenterology Physician in Sedona, AZ
• Providers in Sedona, AZ by specialty
• Gastroenterology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; 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.