Active NPI
Janie Hiesirman-Gorak
- Specialist
- Show Low, AZ
National Provider Identifier
1871632851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 9852
- Practice address
- 1801 W Deuce of Clubs
#200
Show Low, AZ 85901-2705 - Phone
- (928) 339-4842
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 9852 | AZ | Primary |
Addresses
Primary practice location
1801 W Deuce of Clubs
#200
Show Low, AZ 85901-2705
Mailing address
PO Box 850
Alpine, AZ 85920-0850
Phone (928) 339-4842
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9852 | AZ | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871632851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 850",
"city": "ALPINE",
"state": "AZ",
"postal_code": "859200850",
"telephone_number": "928-339-4842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W DEUCE OF CLUBS",
"address_2": "#200",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859012705",
"telephone_number": "928-339-4842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIESIRMAN-GORAK",
"first_name": "JANIE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AZ",
"license": "9852",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.