Kingman Healthcare, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y007642 Issued in AZ

Legal business name

KINGMAN HEALTHCARE, INC

Practice address

1739 E Beverly Ave Ste 106
Kingman, AZ 86409-3593

Phone

(928) 681-8778

Fax

(928) 681-8779

NPI assigned

Aug 24, 2018

Organization subpart

Yes

Parent organization

KINGMAN HEALTHCARE, INCAs reported in NPPES

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

Authorized official

Name

Mr. Tim Blanchard

Title

Cfo

Phone

(928) 681-8668

Specialties & licenses 3

Addresses

Other names 2

• KRMC Community Pharmacy Doing business as
• Kingman Hospital, Inc Former legal business name

Medicare fee-for-service enrollment

Enrolled in AZ3 enrollments

Enrollment records 3

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917

  6901791367

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Kingman Reg Med Ctr5 organizations share this tax ID, including this one

Part of

Kingman Reg Med Ctr

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Kingman Healthcare, Inc

  • Home Health Agency
  • Kingman, AZ
  • NPI 1174701478
  NPD tax ID
• Kingman Healthcare, Inc

  • Rehabilitation Hospital Unit
  • Kingman, AZ
  • NPI 1184802480
  NPD tax ID
• Kingman Healthcare, Inc

  • Community Based Hospice Care Agency
  • Kingman, AZ
  • NPI 1538347836
  NPD tax ID
• Kingman Healthcare, Inc

  • Urgent Care Clinic/Center
  • Kingman, AZ
  • NPI 1760703805
  NPD tax ID

Locations

Practitioners 430

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karleen Carol Adams, D.O.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Kingman, AZ
  • NPI 1093153207
  Care Compare group NPD
• Wade G Alleman, MD

  • Diagnostic Radiology Physician
  • Kingman, AZ
  • NPI 1134136260
  Care Compare group NPD
• Jason C Allen, D.P.M.

  • Podiatrist
  • Kingman, AZ
  • NPI 1215997069
  Care Compare group NPD
• Stan D Allen, D.O.

  • Orthopaedic Surgery Physician
  • Kingman, AZ
  • NPI 1629043740
  Care Compare group NPD
• Amanda Mercedes Baker, CNM, WHNP-BC

  • Women's Health Nurse Practitioner
  • Kingman, AZ
  • NPI 1871182246
  Care Compare group NPD
• Timothy Baker, FNP-C

  • Family Nurse Practitioner
  • Golden Valley, AZ
  • NPI 1407697857
  Care Compare group NPD
• Brent J Bedke, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Kingman, AZ
  • NPI 1417186305
  Care Compare group NPD
• Jeremiah J. Bee, CRNA

  • Certified Registered Nurse Anesthetist
  • Phoenix, AZ
  • NPI 1376980946
  Care Compare group NPD
• Christian Beesley

  • Certified Registered Nurse Anesthetist
  • Bullhead City, AZ
  • NPI 1336917319
  Care Compare group NPD
• Erin E. Black, FNP-C

  • Family Nurse Practitioner
  • Kingman, AZ
  • NPI 1750161493
  Care Compare group NPD
• Kale D Bodily, MD

  • Diagnostic Radiology Physician
  • Kingman, AZ
  • NPI 1174531933
  Care Compare group NPD
• Douglas W Brandt, MD

  • Diagnostic Radiology Physician
  • Kingman, AZ
  • NPI 1184821092
  Care Compare group NPD

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1992286298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-757-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 E BEVERLY AVE STE 106",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093593",
            "telephone_number": "928-681-8778",
            "fax_number": "928-681-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGMAN HEALTHCARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KINGMAN HEALTHCARE, INC",
        "enumeration_date": "2018-08-24",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "928-681-8668",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AZ",
            "license": "Y007642",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "AZ",
            "license": "Y007642",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y007642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KRMC Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kingman Hospital, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kingman Healthcare, Inc
• Kingman Healthcare, Inc
• Kingman Healthcare, Inc
• Kingman Healthcare, Inc
• Kingman Healthcare, Inc
• Kingman Hometown Pharmacy LLC
• Kingman Hospital Inc
• Kingman Kidney Clinic Inc.
• Kingman Neurology
• Kingman No 1 LLC

• All providers in Kingman, AZ
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.