Robert C Wakefield, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3005 Issued in AZ

Practice address

822 E Saguaro St
Florence, AZ 85132

Phone

(480) 235-8545

NPI assigned

Apr 6, 2007

Last updated

Jan 16, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sun Life Family Health Center, Inc.

  dba Sun Life Family Health Center-Florence

  • Federally Qualified Health Center (FQHC)
  • Florence, AZ
  • NPI 1902278252
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1881716967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10110 E HAY LOFT RD",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "852327441",
            "telephone_number": "480-235-8545",
            "fax_number": "520-233-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 E SAGUARO ST",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "85132",
            "telephone_number": "480-235-8545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3005",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valley Respite and Home Care LLC (Siara Assisted Living Home II)
• Valley Respite and Home Care LLC (Siara Assisted Living Home)
• Justin Wayne Vanscoder
• Louis Eduardo Velasco III, M.D.
• Natasha Marie Wagner, LPC
• Deborah Walker, MS, OTR/L
• Mary L Walker, FNP
• Candace Waltz
• Wesley Watson, PT
• We Love Seniors LLC

• Physician Assistant in Florence, AZ
• Providers in Florence, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.