Organization Active NPI

Patakens LTD

  • Family Nurse Practitioner
  • Kingman, AZ
National Provider Identifier
1801075122
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN049098 Issued in AZ
Legal business name
PATAKENS LTD
Practice address
1871 Gates Ave
Kingman, AZ 86401-4017
Phone
(928) 753-3332
Fax
(928) 753-2662
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Authorized official

Name
Cheryl L Webb, RN,MS,C-FNPNPI 1891772083
Title
Nurse Practioner/Owner
Phone
(928) 753-3332

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
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RN049098 AZ Primary

Addresses

Primary practice location

1871 Gates Ave
Kingman, AZ 86401-4017

Mailing address

PO Box 6215
Kingman, AZ 86402-6215
Phone (928) 753-3332

Other identifiers 2

IdentifierTypeStateIssuer
431817MedicaidAZ
DE5233OtherAZRAILROAD MEDICARE

Other names 1

  • DESERT VIEW HEALTH CARE Doing business as

National Provider Directory

National Provider Directory

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": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1801075122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6215",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864026215",
            "telephone_number": "928-753-3332",
            "fax_number": "928-753-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 GATES AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014017",
            "telephone_number": "928-753-3332",
            "fax_number": "928-753-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATAKENS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "WEBB",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "NURSE PRACTIONER/OWNER",
        "authorized_official_telephone_number": "928-753-3332",
        "authorized_official_credential": "RN,MS,C-FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN049098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431817",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE5233",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DESERT VIEW HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.