NPIMap

Organization Active NPI

Northern Arizona University

  • Audiologist-Hearing Aid Fitter
  • Flagstaff, AZ
National Provider Identifier
1912950486
Registry record updated Apr 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
DA1859 Issued in AZ
Legal business name
NORTHERN ARIZONA UNIVERSITY
Practice address
208 E Pine Knoll Dr
Flagstaff, AZ 86011-0001
Phone
(928) 523-8110
Fax
(928) 523-0034
NPI assigned
May 18, 2006
Last updated
Apr 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2023

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

Authorized official

Name
Ms. Stacey Magee, B.S.W.
Title
Operations Assistant Manager
Phone
(928) 523-7776

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid FitterGroup: 193200000X MULTI-SPECIALTY GROUP 237600000X DA1859 AZ Primary

Addresses

Primary practice location

208 E Pine Knoll Dr
Flagstaff, AZ 86011-0001

Mailing address

208 E Pine Knoll Dr
Flagstaff, AZ 86011-0001
Phone (928) 523-8110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100726000284 AZ Part B Supplier - Clinic/Group Practice 0042342115 Receives reassigned benefits from 17 practitioners
2 other NPIs on this enrollment
Practice locations: Flagstaff, AZ

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Az BD of Regents for on Behalf of Northern Az University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

912 Riordan Rd
Flagstaff, AZ 86011
Phone (928) 523-1695

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1912950486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 E PINE KNOLL DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860110001",
            "telephone_number": "928-523-8110",
            "fax_number": "928-523-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E PINE KNOLL DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860110001",
            "telephone_number": "928-523-8110",
            "fax_number": "928-523-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ARIZONA UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "MAGEE",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "OPERATIONS ASSISTANT MANAGER",
        "authorized_official_telephone_number": "928-523-7776",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S.W."
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "AZ",
            "license": "DA1859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.

Verify at the official NPI Registry.