Organization Active NPI

Mary E. Moyer, MD

  • Family Medicine Physician
  • Prescott Valley, AZ
National Provider Identifier
1992817134
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19675 Issued in AZ
Legal business name
MARY E. MOYER, MD
Practice address
3251 N Windsong Dr
Prescott Valley, AZ 86314-1222
Phone
(928) 772-2582
Fax
(928) 772-2383
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mr. John C Moyer
Title
Chief Financial Officer
Phone
(928) 778-1251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 19675 AZ Primary

Addresses

Primary practice location

3251 N Windsong Dr
Prescott Valley, AZ 86314-1222

Mailing address

47 N French Dr
Prescott, AZ 86303-6247
Phone (928) 778-1251

Other identifiers 2

IdentifierTypeStateIssuer
112590OtherAZACCHS
AZ0325350OtherAZBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1992817134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N FRENCH DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863036247",
            "telephone_number": "928-778-1251",
            "fax_number": "928-778-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3251 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141222",
            "telephone_number": "928-772-2582",
            "fax_number": "928-772-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY E. MOYER, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MOYER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "928-778-1251",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "19675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCHS",
            "identifier": "112590",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0325350",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.