Quail Ridge Medical LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

QUAIL RIDGE MEDICAL LLC

Practice address

2331 Hualapai Mountain Rd
Suite a
Kingman, AZ 86401-6207

Phone

(928) 529-5086

Fax

(928) 529-5089

NPI assigned

Nov 20, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Ernest Shayne Monson, NP, DC

Title

Owner/Authorized Official

Phone

(928) 529-5086

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1447977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1902270424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 HUALAPAI MOUNTAIN RD",
            "address_2": "SUITE A",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016207",
            "telephone_number": "928-529-5086",
            "fax_number": "928-529-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 HUALAPAI MOUNTAIN RD",
            "address_2": "SUITE A",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864016207",
            "telephone_number": "928-529-5086",
            "fax_number": "928-529-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAIL RIDGE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-20",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "MONSON",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "SHAYNE",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "928-529-5086",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP, DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Kingman, AZ
• Providers in Kingman, 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 Jul 15, 2016; 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.