Organization Active NPI

Cardiac & Peripheral Vascular Specials of Northern Arizona

  • Specialist
  • Flagstaff, AZ
National Provider Identifier
1770762841
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CARDIAC & PERIPHERAL VASCULAR SPECIALS OF NORTHERN ARIZONA
Practice address
1515 E Cedar Ave Ste D-2
Flagstaff, AZ 86004-1638
Phone
(928) 213-1051
Fax
(928) 213-1053
NPI assigned
Oct 25, 2007
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Mrs. Rebecca Foster
Title
Office Manager
Phone
(928) 213-1051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1515 E Cedar Ave Ste D-2
Flagstaff, AZ 86004-1638

Mailing address

2532 N 4TH St
Flagstaff, AZ 86004-3712
Phone (928) 213-1051

Other identifiers 1

IdentifierTypeStateIssuer
983206MedicaidAZ

Other names 1

  • CPVS Other name

National Provider Directory

National Provider Directory

Locations

1515 E Cedar Ave
Ste D-2
Flagstaff, AZ 86004
Phone (928) 213-1051

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1770762841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2532 N 4TH ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860043712",
            "telephone_number": "928-213-1051",
            "fax_number": "928-213-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E CEDAR AVE STE D-2",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041638",
            "telephone_number": "928-213-1051",
            "fax_number": "928-213-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIAC & PERIPHERAL VASCULAR SPECIALS OF NORTHERN ARIZONA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-213-1051",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "983206",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CPVS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.