Prescott Cardiology, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

26235 Issued in AZ

Legal business name

PRESCOTT CARDIOLOGY, PC

Practice address

804 Ainsworth Dr
Suite 102
Prescott, AZ 86301-1624

Phone

(928) 776-0601

Fax

(928) 776-0620

NPI assigned

May 16, 2006

Last updated

Nov 17, 2016By 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

Mr. Douglas Wayne Rothrock, M.D.

Title

Owner/Provider

Phone

(928) 776-0601

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1902858533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 AINSWORTH DR",
            "address_2": "SUITE 102",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011624",
            "telephone_number": "928-776-0601",
            "fax_number": "928-776-0620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 AINSWORTH DR",
            "address_2": "SUITE 102",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011624",
            "telephone_number": "928-776-0601",
            "fax_number": "928-776-0620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT CARDIOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "ROTHROCK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "928-776-0601",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "26235",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "438780",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Precision Spinal Care PLLC
• Prescott Addiction Recovery Center LLC (Parc)
• Prescott Addiction Recovery Center LLC
• Prescott Anesthesia PLLC
• Prescott Area Recovery Centers
• Prescott Community Counseling
• Prescott Complete Care, PLLC
• Prescott Concierge Care PLLC
• Prescott Dentistry, PLLC
• Prescott Detox Center, LLC

• Specialist in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.