OB-GYN Women'S Center, PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

OB-GYN WOMEN'S CENTER, PC

Practice address

3003 Highway 95
Suite 39
Bullhead City, AZ 86429

Phone

(928) 758-1010

Fax

(928) 758-1428

NPI assigned

Jun 21, 2007

Organization subpart

No

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

Authorized official

Name

Diane Pituch Immesberger

Title

Administrative Assistant

Phone

(928) 514-8602

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1992901672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 HIGHWAY 95",
            "address_2": "SUITE 39",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86429",
            "telephone_number": "928-758-1010",
            "fax_number": "928-758-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 HIGHWAY 95",
            "address_2": "SUITE 39",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "86429",
            "telephone_number": "928-758-1010",
            "fax_number": "928-758-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB-GYN WOMEN'S CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "IMMESBERGER",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "PITUCH",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "928-514-8602"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145525",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.