Vanguard Medical Associates, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VANGUARD MEDICAL ASSOCIATES, PLLC

Practice address

1000 Willow Creek Rd
Suite B
Prescott, AZ 86301-1645

Phone

(928) 277-4458

NPI assigned

Apr 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. K. Mujib Haque, M.D.

Title

Ceo

Phone

(602) 312-0185

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871550038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 10306",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "86304",
            "telephone_number": "928-277-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WILLOW CREEK RD",
            "address_2": "SUITE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011645",
            "telephone_number": "928-277-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD MEDICAL ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAQUE",
        "authorized_official_first_name": "K. MUJIB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-312-0185",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI",
            "identifier": "1538155379",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger A. Van Atta, M.D.
• Cheryl B. Vandemark, PT
• Suzanne Vanderkooi, DPT
• Derek Vanderroest, PTA
• Hannah Vanderroest, RN
• Megan L. Vanmeter, ATR-BC, LPC-AT/S, &
• Karin Vannieuwenhuizen, P.A.-C
• Vantage Cancer Care - Arizona, S.C.
• Vantage Cancer Care Network of Arizona, S.C.
• Candy Lyn Varaksin, RRT

• Internal Medicine Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.