Mark Allen Lawrence, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1845 Issued in AZ

Practice address

JCT US Hwy 160 & Navajo Route 35 Red Mesa
Teecnospos, AZ 86514

Phone

(928) 656-5165

Fax

(928) 656-5164

NPI assigned

Oct 3, 2005

Last updated

Feb 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teec Nos Pos, AZ
  • NPI 1477615789
  NPD (past)

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1912994252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HCR 6100 BOX 30",
            "city": "TEECNOSPOS",
            "state": "AZ",
            "postal_code": "86514",
            "telephone_number": "928-656-5165",
            "fax_number": "928-656-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JCT US HWY 160 & NAVAJO ROUTE 35 RED MESA",
            "city": "TEECNOSPOS",
            "state": "AZ",
            "postal_code": "86514",
            "telephone_number": "928-656-5165",
            "fax_number": "928-656-5164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "1845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06831371",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09358251",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric McKenzie Howser, RN
• Charles William Hudson II, RN MSN
• Brenda Camille Johnson, M.D.
• Nancy D. Kester, RN
• John Kenneth Kosik, D.O.
• John Vincent Linhart, DMD
• Pauline Sojin Linhart, DDS
• Fannie Lookingglass, LMSW
• Judith Ann Mather, RN
• Betty G. McCurtain, RN

• Physician Assistant in Teec Nos Pos, AZ
• Providers in Teec Nos Pos, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.