NPIMap

Organization Active NPI

Sonoran Family Practice

  • Physician Assistant
  • Coolidge, AZ
National Provider Identifier
1770748477
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1252 Issued in AZ
Legal business name
SONORAN FAMILY PRACTICE
Practice address
171 W Central Ave
Coolidge, AZ 85228-4405
Phone
(520) 723-7726
Fax
(520) 723-4513
NPI assigned
Jul 22, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Edward J. Powell, PA-CNPI 1588734750
Title
PA-C
Phone
(520) 723-7726

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X 1252 AZ Primary

Addresses

Primary practice location

171 W Central Ave
Coolidge, AZ 85228-4405

Mailing address

171 W Central Ave
Coolidge, AZ 85228-4405
Phone (520) 723-7726

National Provider Directory

National Provider Directory

Locations

171 W Central Ave
Coolidge, AZ 85128
Phone (520) 723-7726

Practitioners & affiliated clinicians

Practitioners 1

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": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1770748477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 W CENTRAL AVE",
            "city": "COOLIDGE",
            "state": "AZ",
            "postal_code": "852284405",
            "telephone_number": "520-723-7726",
            "fax_number": "520-723-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 W CENTRAL AVE",
            "city": "COOLIDGE",
            "state": "AZ",
            "postal_code": "852284405",
            "telephone_number": "520-723-7726",
            "fax_number": "520-723-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONORAN FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "520-723-7726",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coolidge, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.