Organization Active NPI

Red Tail Hawk Ranch PLLC

  • Addiction Medicine (Preventive Medicine) Physician
  • Kingman, AZ
National Provider Identifier
1811872153
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
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

Updated by the provider on Apr 28, 2026

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

Authorized official

Name
Michael Edward Sheehy, DONPI 1174681126
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)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 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": "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.

Verify at the official NPI Registry.