Nicole Rae Pangborn, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6944 Issued in AZ

Practice address

95 Soldiers Pass Rd Ste B2
Sedona, AZ 86336-4781

Phone

(928) 203-4844

Fax

(928) 203-4497

NPI assigned

Nov 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: nicole.pangborn@hhp.directbygreenway.com

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1962915967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 SOLDIERS PASS RD STE B2",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863364781",
            "telephone_number": "928-203-4844",
            "fax_number": "928-203-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 SOLDIERS PASS RD STE B2",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863364781",
            "telephone_number": "928-203-4844",
            "fax_number": "928-203-4497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "587 Prosser Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "NY",
            "postal_code": "147019350",
            "country_code": "US",
            "telephone_number": "716-640-8129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANGBORN",
        "first_name": "NICOLE",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Sedona, AZ
• Providers in Sedona, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.