Individual provider Active NPI

Pamela Ing-Dobrota, RD

  • Registered Dietitian
  • Cottonwood, AZ
National Provider Identifier
1972051084
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
680640 Issued in AZ
Practice address
269 S Candy LN
Cottonwood, AZ 86326-4158
Phone
(928) 639-6575
Fax
(928) 639-6340
NPI assigned
Sep 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 680640 AZ Primary

Addresses

Primary practice location

269 S Candy LN
Cottonwood, AZ 86326-4158

Mailing address

1200 N Beaver St
Payer Credentialing
Flagstaff, AZ 86001-3118
Phone (928) 213-6235

Other identifiers 1

IdentifierTypeStateIssuer
680640OtherAZCOMMISSION ON DIETETIC REGISTRATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170207002469 AZ Practitioner - Registered Dietitian Or Nutrition Professional 6204119704 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366

269 S Candy LN
Cottonwood, AZ 86326-4158
Phone (928) 639-6000

340 S Willard St
Cottonwood, AZ 86326-4126
Phone (928) 639-6025

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
680640AZMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Medical Center CurrentSince Apr 1, 2017 Accepting new patients
Verde Valley Medical Center Current Accepting new patients
Flagstaff Pathology Associates Current Accepting new patients
Flagstaff Medical Center Current Accepting new patients
Verde Valley Medical Center CurrentSince Jan 14, 2017 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Dec 1, 2018 Accepting new patients
Northern Arizona Healthcare Corporation CurrentSince Dec 1, 2018 Accepting new patients

Locations

1298 W Finnie Flat Rd
Ste 101
Camp Verde, AZ 86322
Phone (928) 639-5555

450 S Willard St
Cottonwood, AZ 86326
Phone (928) 649-7991

340 S Willard St
Ste 201
Cottonwood, AZ 86326
Phone (928) 634-5551

199 S Candy Ln
Ste 1A
Cottonwood, AZ 86326
Phone (602) 634-5551

269 S Candy Ln
Cottonwood, AZ 86326
Phone (928) 634-2251

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

61 Bell Rock Plz
Ste A
Sedona, AZ 86351
Phone (928) 204-4999

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1474070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1972051084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "PAYER CREDENTIALING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6235",
            "fax_number": "928-213-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 S CANDY LN",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264158",
            "telephone_number": "928-639-6575",
            "fax_number": "928-639-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ING-DOBROTA",
        "first_name": "PAMELA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-17",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "680640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMISSION ON DIETETIC REGISTRATION",
            "identifier": "680640",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.