NPIMap

Organization Active NPI

Akdhc, LLC

  • Nephrology Physician
  • Flagstaff, AZ
National Provider Identifier
1962737890
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
3500 Issued in AZ
Legal business name
AKDHC, LLC
Practice address
77 W Forest Ave, Ste 302
Akdhc, LLC
Flagstaff, AZ 86001
Phone
(928) 213-9460
Fax
(928) 213-9465
NPI assigned
Oct 9, 2009
Last updated
Nov 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Authorized official

Name
Ms. Kristen Klein
Title
Director of Physician Services
Phone
(602) 997-0484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 3500 AZ Primary

Addresses

Primary practice location

77 W Forest Ave, Ste 302
Akdhc, LLC
Flagstaff, AZ 86001

Mailing address

3333 E Camelback Rd Ste 180
Phoenix, AZ 85018-2396
Phone (602) 759-6883

Other identifiers 1

IdentifierTypeStateIssuer
642159MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040211000250 AZ Part B Supplier - Clinic/Group Practice 8123912136 Receives reassigned benefits from 152 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 41

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

View all 41

National Provider Directory

National Provider Directory
Tax ID family
Akdhc - Fountain Hills Family Practice92 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

Practitioners & affiliated clinicians

Practitioners 4

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": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1962737890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182396",
            "telephone_number": "602-759-6883",
            "fax_number": "602-224-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE, STE 302",
            "address_2": "AKDHC, LLC",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-213-9460",
            "fax_number": "928-213-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AKDHC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-09",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "DIRECTOR OF PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "602-997-0484",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": "3500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "642159",
            "state": "AZ"
        }
    ],
    "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 Nov 27, 2024; 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.