Active NPI
Red Tail Hawk Ranch PLLC
- Addiction Medicine (Preventive Medicine) Physician
- Kingman, AZ
National Provider Identifier
1811872153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Preventive Medicine) Physician
- Legal business name
- RED TAIL HAWK RANCH PLLC
- Practice address
- 3462 E Lawman Dr
Kingman, AZ 86401-6591 - Phone
- (702) 274-8220
- Fax
- (928) 251-8079
- NPI assigned
- Aug 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Edward Sheehy, DO
- Title
- Medical Director
- Phone
- (702) 274-8220
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Preventive Medicine) Physician | 2083A0300X | Primary |
Addresses
Primary practice location
3462 E Lawman Dr
Kingman, AZ 86401-6591
Mailing address
3462 E Lawman Dr
Kingman, AZ 86401-6591
Phone (702) 274-8220
Other names 1
- John 3:17 Clinic
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Addiction Medicine (Preventive Medicine) Physician
- Kingman, AZ
- NPI 1174681126
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754438400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1777334400000",
"number": "1811872153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3462 E LAWMAN DR",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864016591",
"telephone_number": "702-274-8220",
"fax_number": "928-251-8079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3462 E LAWMAN DR",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864016591",
"telephone_number": "702-274-8220",
"fax_number": "928-251-8079"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RED TAIL HAWK RANCH PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-08-06",
"last_updated": "2026-04-28",
"certification_date": "2026-04-28",
"status": "A",
"authorized_official_last_name": "SHEEHY",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "EDWARD",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "702-274-8220",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "2083A0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Preventive Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "John 3:17 Clinic",
"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 Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.