Organization Active NPI

Doctor'S Office LLC

  • Family Medicine Physician
  • Prescott, AZ
National Provider Identifier
1770732307
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3779 Issued in AZ
Legal business name
DOCTOR'S OFFICE LLC
Practice address
2078 Willow Creek Rd
Prescott, AZ 86301-5389
Phone
(928) 776-6400
Fax
(855) 633-3142
NPI assigned
Sep 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Mr. Josh Baker
Title
Practice Manager
Phone
(928) 776-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 3779 AZ Primary

Addresses

Primary practice location

2078 Willow Creek Rd
Prescott, AZ 86301-5389

Mailing address

2078 Willow Creek Rd
Prescott, AZ 86301-5389
Phone (928) 776-6400

Other names 1

  • NA Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081023000301 AZ Part B Supplier - Clinic/Group Practice 8123186939 Receives reassigned benefits from 5 practitioners
Practice locations: Prescott, AZ

National Provider Directory

National Provider Directory

Locations

2078 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 776-6400

Interoperability endpoints

  • Direct secure messaging: william.devito@thedoctorsoffice.amazing-direct.com
  • Direct secure messaging: dennislittlemd@thedoctorsoffice.amazing-direct.com
  • Direct secure messaging: tdosysadmin@thedoctorsoffice.amazing-direct.com

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1770732307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2078 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015389",
            "telephone_number": "928-776-6400",
            "fax_number": "855-633-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2078 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015389",
            "telephone_number": "928-776-6400",
            "fax_number": "855-633-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR'S OFFICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-18",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "928-776-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NA",
            "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 Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.