Em Medical Management of Fort Mohave, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

EM MEDICAL MANAGEMENT OF FORT MOHAVE, LLC

Practice address

5330 S Highway 95
Fort Mohave, AZ 86426-9225

Phone

(928) 788-7069

NPI assigned

Sep 8, 2016

Last updated

Sep 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Frederick Johnson, MD

Title

President

Phone

(219) 629-0453

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473379200000",
    "number": "1962959767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 W ALAMOSA DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852485303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 S HIGHWAY 95",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864269225",
            "telephone_number": "928-788-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EM MEDICAL MANAGEMENT OF FORT MOHAVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-629-0453",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Hearts Nursing and Home Care, LLC
• Keegan Michael Drawe, APRN
• Scott Duong, M.D.
• Hailey H Eldridge
• Ryan Ellis, CRNA
• Emergency Medicine Physicians of Mohave County, PLLC
• Emergency Physicians Medical Group Inc
• Nathan John Ethridge, PA-C
• Fort Mohave Dental Care PLLC
• Fort Mohave Emergency Medical Associates Inc

• Emergency Medicine Physician in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• Emergency Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.