Individual provider Active NPI

Michael James Horn, M.D.

  • Emergency Medicine Physician
  • Flagstaff, AZ
National Provider Identifier
1982743282
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
26885 Issued in AZ
Practice address
5055 Van Sickle
Flagstaff, AZ 86001-3829
Phone
(928) 863-0713
Fax
(928) 773-0507
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 26885 AZ Primary

Addresses

Primary practice location

5055 Van Sickle
Flagstaff, AZ 86001-3829

Mailing address

5055 Van Sickle
Flagstaff, AZ 86001-3829
Phone (928) 863-0713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170123001834 SD Practitioner - Emergency Medicine 8123210184 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26885AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center Family Medicine CurrentSince Dec 19, 2016 Accepting new patients
Willard Emergency Physicians Emergency Medicine Past Accepting new patients
Flagstaff Emergency Physicians Emergency Medicine Past Accepting new patients
Verde Valley Medical Center Past Accepting new patients
Professional Pathology Associates, PC Past Accepting new patients

Locations

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1982743282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5055 VAN SICKLE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013829",
            "telephone_number": "928-863-0713",
            "fax_number": "928-773-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5055 VAN SICKLE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013829",
            "telephone_number": "928-863-0713",
            "fax_number": "928-773-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "26885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.