NPIMap

Organization Active NPI

Northern Arizona Dermatology Center PC

  • Dermatology Physician
  • Flagstaff, AZ
National Provider Identifier
1962558569
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NORTHERN ARIZONA DERMATOLOGY CENTER PC
Practice address
1490 N Turquoise Dr
Flagstaff, AZ 86001
Phone
(928) 774-5074
Fax
(928) 779-0884
NPI assigned
Jan 26, 2007
Last updated
May 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Authorized official

Name
Dr. Sara Joy Risner-Rumohr, MDNPI 1922319334
Title
Ceo
Phone
(928) 774-5074

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1490 N Turquoise Dr
Flagstaff, AZ 86001

Mailing address

1490 N Turquoise Dr
Flagstaff, AZ 86001
Phone (928) 774-5074

Other identifiers 13

IdentifierTypeStateIssuer
MICA010529OtherLIABILITY INSURANCE
MICA03976OtherLIABILITY INSURANCE
295114OtherAHCCCS
MICA03876OtherLIABILITY INSURANCE
19361OtherAZ LICENSE
MICA03874OtherLIABILITY INSURANCE
23222OtherAZ LICENSE
20368OtherAZ LICENSE
MICA03872OtherLIABILITY INSURANCE
33121OtherAZ LICENSE
25924OtherAZ LICENSE
30215OtherAZ LICENSE
MICA014013OtherLIABILITY INSURANCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040206000555 AZ Part B Supplier - Clinic/Group Practice 8527951052 Receives reassigned benefits from 11 practitioners
3 other NPIs on this enrollment
Practice locations: Cottonwood, AZ; Flagstaff, AZ; Sedona, AZ

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1962558569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 N TURQUOISE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-774-5074",
            "fax_number": "928-779-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 N TURQUOISE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-774-5074",
            "fax_number": "928-779-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ARIZONA DERMATOLOGY CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "RISNER-RUMOHR",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-774-5074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIABILITY INSURANCE",
            "identifier": "MICA010529",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIABILITY INSURANCE",
            "identifier": "MICA03976",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "295114",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIABILITY INSURANCE",
            "identifier": "MICA03876",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "19361",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIABILITY INSURANCE",
            "identifier": "MICA03874",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "23222",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "20368",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIABILITY INSURANCE",
            "identifier": "MICA03872",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "33121",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "25924",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE",
            "identifier": "30215",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIABILITY INSURANCE",
            "identifier": "MICA014013",
            "state": null
        }
    ],
    "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 May 18, 2026; 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.