NPIMap

Organization Active NPI

Psychiatric Associates of Northern Az PLLC

  • Psychiatry Physician
  • Prescott, AZ
National Provider Identifier
1942333760
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHIATRIC ASSOCIATES OF NORTHERN AZ PLLC
Practice address
141 South McCormick
Suite #200
Prescott, AZ 86303-4731
Phone
(928) 445-8400
Fax
(928) 776-0208
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2015

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

Authorized official

Name
Jeffrey Freeman Penney, MDNPI 1063590297
Title
Partner
Phone
(928) 445-8400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

141 South McCormick
Suite #200
Prescott, AZ 86303-4731

Mailing address

141 South McCormick
Suite #200
Prescott, AZ 86303-4731
Phone (928) 445-8400

Other identifiers 2

IdentifierTypeStateIssuer
1235207424OtherNPI
1063590297OtherNPI

National Provider Directory

National Provider Directory

Locations

141 S McCormick St
Ste 200
Prescott, AZ 86303
Phone (928) 445-0209

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432771200000",
    "number": "1942333760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 SOUTH MCCORMICK",
            "address_2": "SUITE #200",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034731",
            "telephone_number": "928-445-8400",
            "fax_number": "928-776-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SOUTH MCCORMICK",
            "address_2": "SUITE #200",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034731",
            "telephone_number": "928-445-8400",
            "fax_number": "928-776-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC ASSOCIATES OF NORTHERN AZ PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2015-05-28",
        "status": "A",
        "authorized_official_last_name": "PENNEY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "FREEMAN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "928-445-8400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235207424",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1063590297",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.