Robert J Casey DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1955 Issued in AZ

Legal business name

ROBERT J CASEY DO PC

Practice address

5171 Cub Lake Rd Ste 270
Show Low, AZ 85901-7888

Phone

(928) 532-1220

Fax

(928) 532-1222

NPI assigned

Jun 16, 2011

Organization subpart

No

Name

Robert J Casey, DO

Title

Owner

Phone

(928) 532-1220

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 14, 2011.

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1972898013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2930",
            "city": "PINETOP",
            "state": "AZ",
            "postal_code": "859352930",
            "telephone_number": "928-532-1220",
            "fax_number": "928-532-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 CUB LAKE RD STE 270",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017888",
            "telephone_number": "928-532-1220",
            "fax_number": "928-532-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J CASEY DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-532-1220",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "1955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "239683",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.