Eldercare Springs

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

ELDERCARE SPRINGS

Practice address

3620 N Walker St
Flagstaff, AZ 86004-2031

Phone

(928) 635-6750

Fax

(928) 526-5169

NPI assigned

May 16, 2019

Last updated

May 16, 2019By 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

William Shane FisherNPI 1295138568

Title

Owner

Phone

(928) 635-6750

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• William Shane Fisher

  • Adult Care Home Facility
  • Flagstaff, AZ
  • NPI 1295138568
  NPD (past) Authorized official

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

{
    "created_epoch": "1557964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1770149635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30354",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860030354",
            "telephone_number": "928-635-6750",
            "fax_number": "928-526-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 N WALKER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860042031",
            "telephone_number": "928-635-6750",
            "fax_number": "928-526-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERCARE SPRINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-16",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-635-6750"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "618181",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lillian Eklof, DO
• El Rio Santa Cruz Neighborhood Health Center Inc (El Ridge Flagstaff Yale)
• El Rio Santa Cruz Neighborhood Health Center Inc (Elk Ridge Flagstaff University)
• El Rio Santa Cruz Neighborhood Health Center Inc (Elk Ridge Flagstaff 4th)
• El Rio Santa Cruz Neighborhood Health Center, Inc (Elk Ridge Health)
• Elevated Anesthesia LLC
• Elevated Intervention Services, LLC (Elevated Intervention Services)
• Elevated Physical Therapy and Movement
• Averie Elias, PMHNP
• Barbara Elias, PA-C

• Adult Care Home Facility in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Adult Care Home Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.