NPIMap

Organization Active NPI

Southwestern Medical Centers-Az, Inc.

  • Assisted Living Facility
  • Prescott, AZ
National Provider Identifier
1770664641
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
ALC-4785 Issued in AZ
Legal business name
SOUTHWESTERN MEDICAL CENTERS-AZ, INC.
Doing business as
Peppertree Assisted Living Apartments
Practice address
860 Dougherty St
Prescott, AZ 86305-1841
Phone
(928) 778-9777
Fax
(928) 717-0587
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Stan Studer Jr.
Title
Vice President
Phone
(210) 828-5686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X ALC-4785 AZ Primary

Addresses

Primary practice location

860 Dougherty St
Prescott, AZ 86305-1841

Mailing address

1020 NE Loop 410
Suite 640
San Antonio, TX 78209-1204
Phone (210) 828-5686

Other identifiers 1

IdentifierTypeStateIssuer
500993OtherAZACCESS #

Other names 1

  • Peppertree Assisted Living Apartments Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peppertree Assisted Living Apartments2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1020 NE Loop 410
Ste 640
San Antonio, TX 78209

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770664641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 NE LOOP 410",
            "address_2": "SUITE 640",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091204",
            "telephone_number": "210-828-5686",
            "fax_number": "210-824-4669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 DOUGHERTY ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051841",
            "telephone_number": "928-778-9777",
            "fax_number": "928-717-0587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN MEDICAL CENTERS-AZ, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STUDER",
        "authorized_official_first_name": "STAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "210-828-5686",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AZ",
            "license": "ALC-4785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCESS #",
            "identifier": "500993",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peppertree Assisted Living Apartments",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • 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.