Individual provider Active NPI

Stephen William Dahn, M.D.

  • Family Medicine Physician
  • Prescott, AZ
National Provider Identifier
1801863550
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
06840 Issued in AZ
Practice address
999 Division St
Prescott, AZ 86301-1654
Phone
(928) 778-2700
Fax
(928) 778-5974
NPI assigned
Mar 1, 2006
Last updated
Jul 10, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 06840 AZ Primary

Addresses

Primary practice location

999 Division St
Prescott, AZ 86301-1654

Mailing address

999 Division St
Prescott, AZ 86301-1654
Phone (928) 778-2700

Other identifiers 1

IdentifierTypeStateIssuer
203620MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051118000624 AZ Practitioner - Family PracticePractitioner - General Practice 1153349097 Receives reassigned benefits from 1 practitioner
Practice locations: Prescott, AZ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
06840AZMDFamily Medicine Physician
6840AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Evangelical Lutheran Good Samaritan Society Past Accepting new patients
Prescott Village Nursing & Rehabilitation LLC Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Prescott Village Nursing & RehabilitationPrescott, AZ, CCN 035158 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Nov 19, 2024
Nov 19, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1801863550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 DIVISION ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011654",
            "telephone_number": "928-778-2700",
            "fax_number": "928-778-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 DIVISION ST",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011654",
            "telephone_number": "928-778-2700",
            "fax_number": "928-778-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHN",
        "first_name": "STEPHEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "06840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203620",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.