NPIMap

Organization Active NPI

Yavapai County

  • Public Health or Welfare Agency
  • Prescott Valley, AZ
National Provider Identifier
1942539648
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
YAVAPAI COUNTY
Practice address
6717 E 2ND St
Suite D
Prescott Valley, AZ 86314-2659
Phone
(928) 771-3560
Fax
(928) 771-3542
NPI assigned
Dec 9, 2009
Last updated
Feb 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Authorized official

Name
Ms. Vicki Mastriani
Title
Admin Supervisor
Phone
(928) 771-3560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

6717 E 2ND St
Suite D
Prescott Valley, AZ 86314-2659

Mailing address

6717 E 2ND St
Suite D
Prescott Valley, AZ 86314-2659
Phone (928) 771-3560

Other identifiers 1

IdentifierTypeStateIssuer
110025MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000266 AZ Part B Supplier - Clinic/Group Practice 8921919499 Receives reassigned benefits from 29 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cottonwood, AZ; Ash Fork, AZ; Prescott Valley, AZ; Prescott, AZ

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

6717 E 2nd St
Ste D
Prescott Vly, AZ 86314
Phone (928) 771-3560

Practitioners & affiliated clinicians

Practitioners 3

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": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1942539648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6717 E 2ND ST",
            "address_2": "SUITE D",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142659",
            "telephone_number": "928-771-3560",
            "fax_number": "928-771-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6717 E 2ND ST",
            "address_2": "SUITE D",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142659",
            "telephone_number": "928-771-3560",
            "fax_number": "928-771-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAVAPAI COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "MASTRIANI",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "ADMIN SUPERVISOR",
        "authorized_official_telephone_number": "928-771-3560",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110025",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.