Bradshaw Mountain Family Medicine LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN145916 AP7984 Issued in AZ

Legal business name

BRADSHAW MOUNTAIN FAMILY MEDICINE LLC

Practice address

1163 E Old Chisholm Trail Suite C
Dewey, AZ 86327

Phone

(928) 710-1971

Fax

(844) 250-8735

NPI assigned

Jan 2, 2016

Last updated

Jan 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Susan Murphy, FNP-CNPI 1205239324

Title

Owner

Phone

(480) 542-9906

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Murphy, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1205239324
  Authorized official Same address or phone

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

{
    "created_epoch": "1451692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1902262272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 W BASELINE RD STE 182-549",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850416574",
            "telephone_number": "928-683-1170",
            "fax_number": "833-675-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 E OLD CHISHOLM TRAIL SUITE C",
            "city": "DEWEY",
            "state": "AZ",
            "postal_code": "86327",
            "telephone_number": "928-710-1971",
            "fax_number": "844-250-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADSHAW MOUNTAIN FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-02",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-542-9906",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN145916 AP7984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Dewey, AZ
• Providers in Dewey, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.