NPIMap

Organization Active NPI

Kimberly J. Sargent PA-C, PLLC

  • Surgical Physician Assistant
  • Flagstaff, AZ
National Provider Identifier
1962857383
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
#2555 Issued in AZ
Legal business name
KIMBERLY J. SARGENT PA-C, PLLC
Practice address
711 W Aspen Ave
Flagstaff, AZ 86001-5301
Phone
(928) 856-2208
NPI assigned
May 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Authorized official

Name
Kimberly Jo Sargent, PA-C
Title
Owner
Phone
(928) 856-2208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X #2555 AZ Primary

Addresses

Primary practice location

711 W Aspen Ave
Flagstaff, AZ 86001-5301

Mailing address

711 W Aspen Ave
Flagstaff, AZ 86001-5301
Phone (928) 856-2208

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462320000000",
    "number": "1962857383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 W ASPEN AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015301",
            "telephone_number": "928-856-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W ASPEN AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015301",
            "telephone_number": "928-856-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY J. SARGENT PA-C, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-04",
        "last_updated": "2016-05-04",
        "status": "A",
        "authorized_official_last_name": "SARGENT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-856-2208",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "#2555",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 4, 2016; 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.