Organization Active NPI

Alpha Medical Az PLLC

  • Internal Medicine Physician
  • Cottonwood, AZ
National Provider Identifier
1881452886
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ALPHA MEDICAL AZ PLLC
Practice address
699 N 10TH St
Cottonwood, AZ 86326-3712
Phone
(928) 707-0280
NPI assigned
Mar 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
Melissa Hardy
Title
Credentialing/Billing
Phone
(928) 592-9414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

699 N 10TH St
Cottonwood, AZ 86326-3712

Mailing address

699 N 10TH St
Cottonwood, AZ 86326-3712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240702000452 AZ Part B Supplier - Clinic/Group Practice 7214471226 Receives reassigned benefits from 1 practitioner
Practice locations: Cottonwood, AZ

National Provider Directory

National Provider Directory

Locations

699 N 10th St
Cottonwood, AZ 86326
Phone (928) 707-0280

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": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1881452886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 N 10TH ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 N 10TH ST",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263712",
            "telephone_number": "928-707-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPHA MEDICAL AZ PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "HARDY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CREDENTIALING/BILLING",
        "authorized_official_telephone_number": "928-592-9414"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.