Active NPI
Stanford Paul Sadick, D.O.
- Surgery Physician
- Prescott, AZ
National Provider Identifier
1811253230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 3170
- Practice address
- 3908 Twisted Trails
Prescott, AZ 86301-6724 - Phone
- (928) 445-0390
- Fax
- (928) 445-0390
- NPI assigned
- Apr 10, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 3170 | AZ | Primary |
Addresses
Primary practice location
3908 Twisted Trails
Prescott, AZ 86301-6724
Mailing address
3908 Twisted Trails
Prescott, AZ 86301-6724
Phone (928) 445-0390
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3170 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334016000000",
"number": "1811253230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3908 TWISTED TRAILS",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863016724",
"telephone_number": "928-445-0390",
"fax_number": "928-445-0390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3908 TWISTED TRAILS",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863016724",
"telephone_number": "928-445-0390",
"fax_number": "928-445-0390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SADICK",
"first_name": "STANFORD",
"middle_name": "PAUL",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-10",
"last_updated": "2012-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AZ",
"license": "3170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.