Active NPI
Eddie Walid Fakhouri, MD
- Critical Care Medicine (Internal Medicine) Physician
- Flagstaff, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine (Internal Medicine) Physician
- License
- 75978
- Practice address
- 1200 N Beaver St
Flagstaff, AZ 86001-3118 - Phone
- (928) 773-2200
- NPI assigned
- Mar 20, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 2022024150 | MO | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 75978 | AZ | Primary |
Addresses
Primary practice location
1200 N Beaver St
Flagstaff, AZ 86001-3118
Mailing address
1 Hospital Dr
Columbia, MO 65212-3609
Phone (573) 884-1606
Other practice location 1
1 Hospital Dr
Columbia, MO 65212-3609
Phone (573) 884-1606
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366
1215 N Beaver St
Suite 203
Flagstaff, AZ 86001-3126
Phone (928) 773-2249
1895 N Jasper Dr
Flagstaff, AZ 86001-1632
2000 S Thompson St
Flagstaff, AZ 86001-8759
Phone (928) 226-6400
269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000
340 S Willard St
Cottonwood, AZ 86326-4126
Phone (928) 639-6025
7810 N US Hwy 89
Flagstaff, AZ 86004-6255
Phone (928) 522-8375
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Arizona Healthcare Corporation | Family Medicine | Current | Accepting new patients |
| Northern Arizona Healthcare Corporation | Current | Accepting new patients | |
| Flagstaff Pathology Associates | Current | Accepting new patients |
Locations
269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251
1215 N Beaver St
Ste 203
Flagstaff, AZ 86001
Phone (928) 773-2249
1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235
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.
-
- Family Medicine Physician
- Flagstaff, AZ
- NPI 1669914552
-
dba Pathology Associates of Northern AZ
- Anatomic Pathology & Clinical Pathology Physician
- Flagstaff, AZ
- NPI 1306205612
-
dba Northern Arizona Healthcare Children's Health Center
- Multi-Specialty Clinic/Center
- Flagstaff, AZ
- NPI 1235732702
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Guardian Medical Transport
- Land Ambulance
- Flagstaff, AZ
- NPI 1518143205
Hospital
-
dba FMC Behavioral Health Services
- Psychiatric Hospital Unit
- Flagstaff, AZ
- NPI 1649370875
-
- General Acute Care Hospital
- Flagstaff, AZ
- NPI 1780635078
-
- General Acute Care Hospital
- Cottonwood, AZ
- NPI 1346291648
-
dba Northern Arizona Healthcare - Sedona
- General Acute Care Hospital
- Sedona, AZ
- NPI 1538608716
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745798400000",
"number": "1811457674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HOSPITAL DR",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652123609",
"telephone_number": "573-884-1606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N BEAVER ST",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013118",
"telephone_number": "928-773-2200"
}
],
"practiceLocations": [
{
"address_1": "1 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Columbia",
"state": "MO",
"postal_code": "652123609",
"country_code": "US",
"telephone_number": "573-884-1606",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAKHOURI",
"first_name": "EDDIE",
"middle_name": "WALID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-20",
"last_updated": "2025-04-28",
"certification_date": "2025-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MO",
"license": "2022024150",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "AZ",
"license": "75978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.