NPIMap

Individual provider Active NPI

Reece Kirby Hadlock, PA-C

  • Physician Assistant
  • Eagar, AZ
National Provider Identifier
1972802528
Registry record updated Jan 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5006 Issued in AZ
Practice address
606 N Main St
Eagar, AZ 85925-9813
Phone
(928) 333-5333
Fax
(928) 333-5100
NPI assigned
Mar 22, 2011
Last updated
Jan 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5006 AZ Primary
Physician Assistant 363A00000X PA1252 NV

Addresses

Primary practice location

606 N Main St
Eagar, AZ 85925-9813

Mailing address

606 N Main St
Eagar, AZ 85925-9813
Phone (928) 333-5333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120202000836 AZ Practitioner - Physician Assistant 1658554670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White Mountain Regional Medical CenterGroup PAC ID 1951203512, 16 clinicians

Practice addresses (Care Compare)

118 S Mountain Ave
Springerville, AZ 85938-5104
Phone (928) 333-4368

17900 N Porter Rd
Maricopa, AZ 85138-4228
Phone (520) 233-2500

3457 W White Mountain Blvd
Lakeside, AZ 85929-6007
Phone (928) 358-1515

680 E Deuce of Clubs
Show Low, AZ 85901-4829
Phone (928) 596-4580

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1252NVMDBehavior Technician
PA1252NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Healthcare Medical Associates CurrentSince Oct 1, 2016 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jul 16, 2025 Accepting new patients
Summit Healthcare Medical Associates CurrentSince Oct 1, 2016 Accepting new patients
Banner Primary Care Physicians Arizona LLC CurrentSince Jul 16, 2025 Accepting new patients
Summit Healthcare Medical Associates CurrentSince Oct 1, 2016 Accepting new patients

Locations

3457 W White Mountain Blvd
Lakeside, AZ 85929
Phone (888) 264-2127

17900 N Porter Rd
Maricopa, AZ 85138
Phone (520) 233-2500

101 E State Highway 260
Ste G
Payson, AZ 85541
Phone (888) 264-2127

680 E Deuce of Clubs
Show Low, AZ 85901
Phone (888) 264-2127

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1300752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1972802528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 N MAIN ST",
            "city": "EAGAR",
            "state": "AZ",
            "postal_code": "859259813",
            "telephone_number": "928-333-5333",
            "fax_number": "928-333-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 N MAIN ST",
            "city": "EAGAR",
            "state": "AZ",
            "postal_code": "859259813",
            "telephone_number": "928-333-5333",
            "fax_number": "928-333-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLOCK",
        "first_name": "REECE",
        "middle_name": "KIRBY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-22",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5006",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1252",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagar, AZ

Sources for this page

Verify at the official NPI Registry.