NPIMap

Individual provider Active NPI

Andrea L Stone Shayer, MD

  • Family Medicine Physician
  • Cottonwood, AZ
National Provider Identifier
1871578732
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15706 Issued in AZ
Practice address
450 S Willard St
Ste 115
Cottonwood, AZ 86326-6743
Phone
(928) 634-3025
Fax
(928) 649-8800
NPI assigned
Dec 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 15706 AZ
Family Medicine Physician 207Q00000X 15706 AZ Primary

Addresses

Primary practice location

450 S Willard St
Ste 115
Cottonwood, AZ 86326-6743

Mailing address

PO Box 596
Cottonwood, AZ 86326-0596
Phone (928) 634-3025

Other identifiers 1

IdentifierTypeStateIssuer
259053MedicaidAZ

Other names 1

  • Andrea L Stone Professional name

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 Medicine

State licenses

LicenseStateTypeSpecialty
15706AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Havasu Emergency Physicians, PC Emergency Medicine Past Accepting new patients
Cardiac Care, P.C. Past Accepting new patients
Tizon Emergency Associates, PLLC Emergency Medicine Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1871578732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 596",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863260596",
            "telephone_number": "928-634-3025",
            "fax_number": "928-649-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S WILLARD ST",
            "address_2": "STE 115",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266743",
            "telephone_number": "928-634-3025",
            "fax_number": "928-649-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE SHAYER",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "15706",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "15706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259053",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "STONE",
            "middle_name": "L",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.