Arizona Em-1 Medical Services, PC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

Legal business name

ARIZONA EM-1 MEDICAL SERVICES, PC

Practice address

520 Rose LN
Wickenburg Community Hospital
Wickenburg, AZ 85390-1447

Phone

(928) 684-5421

NPI assigned

Jan 23, 2013

Last updated

Jan 23, 2013By 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

Dr. Donald T Godbold, M.D.

Title

Owner

Phone

(800) 444-7009

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358899200000",
    "number": "1972841146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 S PALAFOX ST",
            "address_2": "SUITE 300",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325025960",
            "telephone_number": "800-444-7009",
            "fax_number": "800-305-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 ROSE LN",
            "address_2": "WICKENBURG COMMUNITY HOSPITAL",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901447",
            "telephone_number": "928-684-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA EM-1 MEDICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2013-01-23",
        "status": "A",
        "authorized_official_last_name": "GODBOLD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-444-7009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acute Care Nurse Practitioner in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• Acute Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; 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.