Active NPI
Arizona Em-I Medical Services
- Nurse Practitioner
- Douglas, AZ
National Provider Identifier
1891070520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- ARIZONA EM-I MEDICAL SERVICES
- Practice address
- 2174 W Oak Ave
Douglas, AZ 85607-6003 - Phone
- (520) 364-7931
- NPI assigned
- Oct 13, 2011
- Last updated
- Oct 13, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Donald T Godbold, M.D.
- Title
- President
- Phone
- (800) 444-7009
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
2174 W Oak Ave
Douglas, AZ 85607-6003
Mailing address
815 S Palafox St
Suite 300
Pensacola, FL 32502-5960
Phone (800) 444-7009
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040421000835 | AZ | Part B Supplier - Clinic/Group Practice | 8325034812 |
Receives reassigned benefits from 53 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Yuma, AZ |
Other NPIs on the same Medicare enrollment 5
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Emergency Medicine Physician
- Cottonwood, AZ
- NPI 1407805658
O20040421000835
-
- Emergency Medicine Physician
- Lake Havasu City, AZ
- NPI 1619926532
O20040421000835
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318464000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1318464000000",
"number": "1891070520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 S PALAFOX ST",
"address_2": "SUITE 300",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325025960",
"telephone_number": "800-444-7009",
"fax_number": "800-305-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2174 W OAK AVE",
"city": "DOUGLAS",
"state": "AZ",
"postal_code": "856076003",
"telephone_number": "520-364-7931"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ARIZONA EM-I MEDICAL SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2011-10-13",
"last_updated": "2011-10-13",
"status": "A",
"authorized_official_last_name": "GODBOLD",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "T",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "800-444-7009",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglas, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.