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WEST SEDONA FAMILY PRACTICE PLLC NPI 1114384609


NPI Information

NPI: 1114384609
Provider Name: WEST SEDONA FAMILY PRACTICE PLLC
Classification: Physician Assistant - 363A00000X
Entity Type: Organization

CLIA Number: 03D2114996

Address:
2155 W STATE ROUTE 89A
SUITE 113
SEDONA, AZ
ZIP 86336
Phone: (928) 204-2540
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WEST SEDONA FAMILY PRACTICE PLLC is a physician assistant in Sedona, AZ. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. WEST SEDONA FAMILY PRACTICE PLLC NPI is 1114384609. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2155 W STATE ROUTE 89A
SUITE 113
SEDONA, AZ
ZIP 86336-468
Phone: (928) 204-2540
Fax: (928) 204-9070

The provider's authorized official is Barbara A Cline .
The authorized official title is Physician Assistant and has the following contact phone number (928) 204-2540.

The CLIA number assigned to this NPI record is 03D2114996 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2016 and was last updated on 7/14/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician Assistant4243ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1E7287ZOTHERPROVIDER #
21164446043OTHERARIZONAINDIVIDUAL NPI
3P59872MEDICARE UPINARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.