Gloria Jean Eagle, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1932 Issued in AZ

Practice address

1200 W Mohave Rd
Parker, AZ 85344-6349

Phone

(928) 669-7380

Fax

(928) 669-7371

NPI assigned

Mar 24, 2006

Last updated

Jul 5, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17369/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-usa.unify.chbase.com/org/lapaz-b154c12f

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• La Paz Regional Hospital Inc

  • Critical Access Hospital
  • Parker, AZ
  • NPI 1053684555
  Medicare reassignment
• La Paz Regional Hospital, Inc.

  dba La Paz Medical Services-Quartzsite

  • Rural Health Clinic/Center
  • Quartzsite, AZ
  • NPI 1013932938
  NPD
• Kevin S. Klopfenstein M.D. P.C.

  • Internal Medicine Physician
  • Parker, AZ
  • NPI 1043355175

  Medical

  NPD (past)
• Donald Woo Lee, M.D., a Professional Corporation

  • Internal Medicine Physician
  • Temecula, CA
  • NPI 1841677663
  NPD (past)

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1770543506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S CALIFORNIA AVE",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853444467",
            "telephone_number": "928-669-6151",
            "fax_number": "928-669-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W MOHAVE RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446349",
            "telephone_number": "928-669-7380",
            "fax_number": "928-669-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLE",
        "first_name": "GLORIA",
        "middle_name": "JEAN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "1932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158539",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "A20324620",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00279265",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DHHS IHS Phoenix Area (Parker Indian Hospital)
• Veronica Distefano
• Janai Dudney
• Amber Lynn Duncan, RN
• Lori Ann Dunnington, RN
• Heidi Anne Eikom, RN, PHN
• David Elkin
• Emcare Physician Providers, Inc
• Yvonne Juanita Epps-Giddings
• Candy H Escorza

• Medical Physician Assistant in Parker, AZ
• Providers in Parker, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.