Heart Institute of Northern Arizona LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

HEART INSTITUTE OF NORTHERN ARIZONA LLC

Practice address

1753 Airway Ave
Suite B
Kingman, AZ 86409-3720

Phone

(928) 692-6200

Fax

(928) 692-9474

NPI assigned

Nov 10, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Gary Guidry

Title

Ceo

Phone

(704) 815-7804

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254787200000",
    "number": "1922089416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 SIKES PL",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778141",
            "telephone_number": "704-815-7789",
            "fax_number": "888-401-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 AIRWAY AVE",
            "address_2": "SUITE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093720",
            "telephone_number": "928-692-6200",
            "fax_number": "928-692-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART INSTITUTE OF NORTHERN ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2009-10-06",
        "status": "A",
        "authorized_official_last_name": "GUIDRY",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-815-7804",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "930348",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "470000205",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197211",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia D Haydon, D.C.
• Joseph Haydu, M.D.
• Susan M Haynes
• Healthcare Management Professional, Inc. (The Gardens Rehab & Care Center)
• Heart Institute of Northern Arizona LLC
• Margot D Henderson, P.A.-C.
• Shirley Kathryn Henderson, LICENSED COUNSELOR
• Tawni Hendriks, FDN-P
• Maikel Hernandez Diaz, PA-C
• Dyanne Marie Hernandez, FNP-BC

• Multi-Specialty Clinic/Center in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Multi-Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; 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.