| Summit Healthcare Medical Associates | |
|
4951 S White Mountain Rd Bldg A Show Low AZ 85901-7827 | |
| (928) 537-6700 | |
| (928) 537-9945 |
| Full Name | Summit Healthcare Medical Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 4951 S White Mountain Rd Bldg A, Show Low, Arizona |
| Authorized Official Name and Position | Jessica D Mcginnis (CHIEF OF PHYSICIAN SERVICES OFFICER) |
| Authorized Official Contact | 9285376871 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Healthcare Medical Associates 4951 S White Mountain Rd Bldg A Show Low AZ 85901-7827 Ph: (928) 537-6700 | Summit Healthcare Medical Associates 4951 S White Mountain Rd Bldg A Show Low AZ 85901-7827 Ph: (928) 537-6700 |
| NPI Number | 1467878108 |
|---|---|
| Provider Enumeration Date | 03/05/2014 |
| Last Update Date | 08/24/2026 |
| Certification Date | 08/24/2026 |
| Medicare PECOS PAC ID | 8729205737 |
|---|---|
| Medicare Enrollment ID | O20140815000931 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467878108 | NPI | - | NPPES |
| Provider Name | Richard P Shaughnessy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689776254 PECOS PAC ID: 6305838384 Enrollment ID: I20040331000611 |
| Provider Name | Bethanie B Sorensen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396747044 PECOS PAC ID: 6709879661 Enrollment ID: I20040406001119 |
| Provider Name | Curtis J Jones |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689756694 PECOS PAC ID: 2769460948 Enrollment ID: I20040713000932 |
| Provider Name | Riyaz a Sumar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1144212721 PECOS PAC ID: 9830160399 Enrollment ID: I20040805001464 |
| Provider Name | Ernesto Gomez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386685055 PECOS PAC ID: 5294704532 Enrollment ID: I20041001001001 |
| Provider Name | Larry Travis Heap |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366418113 PECOS PAC ID: 5991752909 Enrollment ID: I20050401000473 |
| Provider Name | Patrick a Brighton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124050885 PECOS PAC ID: 7315922531 Enrollment ID: I20050420000395 |
| Provider Name | Dax K Trujillo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699848382 PECOS PAC ID: 7012957731 Enrollment ID: I20050511000916 |
| Provider Name | Simranjit S Galhotra |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962407601 PECOS PAC ID: 1254375413 Enrollment ID: I20050617000692 |
| Provider Name | Anthony D Greco |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912978867 PECOS PAC ID: 5092730077 Enrollment ID: I20051008000251 |
| Provider Name | Scott B Sherwood |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720133663 PECOS PAC ID: 0446278196 Enrollment ID: I20051110000693 |
| Provider Name | Nathan M Brooks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093763377 PECOS PAC ID: 3375564834 Enrollment ID: I20051212000708 |
| Provider Name | Jeffrey a Levison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467405894 PECOS PAC ID: 4486660974 Enrollment ID: I20060221000420 |
| Provider Name | David Netz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407828528 PECOS PAC ID: 9739198953 Enrollment ID: I20060418000095 |
| Provider Name | Andrea M Saugstad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265442685 PECOS PAC ID: 5395741201 Enrollment ID: I20061017000580 |
| Provider Name | Patrick W Connelly |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619965548 PECOS PAC ID: 1658266325 Enrollment ID: I20061026000552 |
| Provider Name | Bonifasiyo K Ssennyamantono |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902813678 PECOS PAC ID: 4082611280 Enrollment ID: I20061101000157 |
| Provider Name | Hiva Vakil |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356480172 PECOS PAC ID: 4587760665 Enrollment ID: I20070507000258 |
| Provider Name | Adhar Seth |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164539755 PECOS PAC ID: 2062462666 Enrollment ID: I20070807000582 |
| Provider Name | Cara L Quade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437112240 PECOS PAC ID: 9537239058 Enrollment ID: I20080610000091 |
| Provider Name | Craig G Brady |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447224548 PECOS PAC ID: 8022004563 Enrollment ID: I20081022000701 |
| Provider Name | Jacob B Oldham |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033109632 PECOS PAC ID: 8325067804 Enrollment ID: I20090105000257 |
| Provider Name | Lorne W Murray |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609857705 PECOS PAC ID: 1153476155 Enrollment ID: I20090826000897 |
| Provider Name | Koushik Nag |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699892059 PECOS PAC ID: 4981759107 Enrollment ID: I20090911000045 |
| Provider Name | Burke Gary Delange |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1801866876 PECOS PAC ID: 8527036474 Enrollment ID: I20090917000601 |
| Provider Name | Timothy R Penniston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144243692 PECOS PAC ID: 8729035472 Enrollment ID: I20090928000360 |
| Provider Name | Hursh S Naik |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1124139423 PECOS PAC ID: 9436295524 Enrollment ID: I20091002000325 |
| Provider Name | James B Olack |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1669686135 PECOS PAC ID: 3274670518 Enrollment ID: I20100902001022 |
| Provider Name | Susan I Lasala-wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457667016 PECOS PAC ID: 2860689460 Enrollment ID: I20101208001008 |
| Provider Name | Tomas Rivera-bonilla |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1881855294 PECOS PAC ID: 1850561820 Enrollment ID: I20110830000556 |
| Provider Name | Reece K Hadlock |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972802528 PECOS PAC ID: 1658554670 Enrollment ID: I20120202000836 |
| Provider Name | Arun S Patil |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1093955908 PECOS PAC ID: 3971653130 Enrollment ID: I20120628000052 |
| Provider Name | Jason R Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669517611 PECOS PAC ID: 7012014376 Enrollment ID: I20130226000478 |
| Provider Name | Nathaniel D Evans |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104054378 PECOS PAC ID: 4284873134 Enrollment ID: I20130625000592 |
| Provider Name | Eericca M Bickley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023250529 PECOS PAC ID: 7214177674 Enrollment ID: I20130708000298 |
| Provider Name | Devin Lane Porter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992144943 PECOS PAC ID: 5991947152 Enrollment ID: I20130819000125 |
| Provider Name | Chad B Brimhall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699095976 PECOS PAC ID: 5193968857 Enrollment ID: I20130828000044 |
| Provider Name | Raelynn M Musick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073946562 PECOS PAC ID: 0547494809 Enrollment ID: I20130930000280 |
| Provider Name | Michael J Hervey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922132414 PECOS PAC ID: 3577663319 Enrollment ID: I20131113000632 |
| Provider Name | Brandie D Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093148991 PECOS PAC ID: 5698901676 Enrollment ID: I20131121001105 |
| Provider Name | Geoffrey D Cornelsen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447415161 PECOS PAC ID: 6305073370 Enrollment ID: I20140814002691 |
| Provider Name | Bahar Golestan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811151376 PECOS PAC ID: 5890018626 Enrollment ID: I20141230001937 |
| Provider Name | Joseph N Pack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578765012 PECOS PAC ID: 4688730062 Enrollment ID: I20150610001765 |
| Provider Name | Benjamin R Richardson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215222013 PECOS PAC ID: 0941510598 Enrollment ID: I20151218001730 |
| Provider Name | Deann M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992190201 PECOS PAC ID: 3971805292 Enrollment ID: I20160104002047 |
| Provider Name | Quezia Hall |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073985651 PECOS PAC ID: 8820391840 Enrollment ID: I20160126001680 |
| Provider Name | Scott Hanson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306248596 PECOS PAC ID: 2264737238 Enrollment ID: I20160229002953 |
| Provider Name | Ryan James Varga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184060808 PECOS PAC ID: 4688978505 Enrollment ID: I20160525001866 |
| Provider Name | Curtis Vance Birdno |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063740884 PECOS PAC ID: 5294865226 Enrollment ID: I20160622002118 |
| Provider Name | Douglas B Masson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1114901238 PECOS PAC ID: 2961664750 Enrollment ID: I20160721001265 |
| Provider Name | Brian William Goodman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497165732 PECOS PAC ID: 2668754722 Enrollment ID: I20170125000932 |
| Provider Name | Corwin Ellsworth |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962634246 PECOS PAC ID: 8729360706 Enrollment ID: I20170127000355 |
| Provider Name | Christopher J Flake |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699125112 PECOS PAC ID: 4183909278 Enrollment ID: I20170403001783 |
| Provider Name | Daniel G Brewer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538570536 PECOS PAC ID: 2961700265 Enrollment ID: I20170809001642 |
| Provider Name | Shane Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255859567 PECOS PAC ID: 9638444342 Enrollment ID: I20171005002755 |
| Provider Name | Sandra Walker Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770749202 PECOS PAC ID: 0547304412 Enrollment ID: I20171106003241 |
| Provider Name | Maggie B Price |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700217718 PECOS PAC ID: 3577821396 Enrollment ID: I20171227000638 |
| Provider Name | Upamanyu Rampal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790195741 PECOS PAC ID: 9830459981 Enrollment ID: I20180209000710 |
| Provider Name | Brian Ellis Paronto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922501378 PECOS PAC ID: 2062776016 Enrollment ID: I20180430000602 |
| Provider Name | Matthew Waite |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760861082 PECOS PAC ID: 4981951456 Enrollment ID: I20180716002936 |
| Provider Name | Cameron Tregaskes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184030454 PECOS PAC ID: 4385969633 Enrollment ID: I20180726002557 |
| Provider Name | Joseph Eich |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619221694 PECOS PAC ID: 5890925135 Enrollment ID: I20180727002005 |
| Provider Name | Amber Lynne Hunt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376035584 PECOS PAC ID: 4587913744 Enrollment ID: I20180821002335 |
| Provider Name | Randall Crockett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295897957 PECOS PAC ID: 7517060601 Enrollment ID: I20180827001713 |
| Provider Name | Courtney Ann Contreras Vallery |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821576638 PECOS PAC ID: 6709124498 Enrollment ID: I20190204002929 |
| Provider Name | David Clay Lazenby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992143531 PECOS PAC ID: 4486884814 Enrollment ID: I20190401002029 |
| Provider Name | Constance L Collman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174187546 PECOS PAC ID: 0941536460 Enrollment ID: I20190722002556 |
| Provider Name | Randal Lloyd Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235581539 PECOS PAC ID: 9234467341 Enrollment ID: I20190828001206 |
| Provider Name | Mary Storts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952958472 PECOS PAC ID: 8921339508 Enrollment ID: I20191011002336 |
| Provider Name | Ralph Adam Patterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558719468 PECOS PAC ID: 2466745575 Enrollment ID: I20191024001016 |
| Provider Name | Lee R Wilde |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700101060 PECOS PAC ID: 1052554847 Enrollment ID: I20191224000580 |
| Provider Name | Courtney Ann Mackinnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861023921 PECOS PAC ID: 4789012667 Enrollment ID: I20200309001384 |
| Provider Name | Brett Joseph Brewer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538516778 PECOS PAC ID: 4981035987 Enrollment ID: I20200506003399 |
| Provider Name | David C Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417480047 PECOS PAC ID: 0941532048 Enrollment ID: I20200513003204 |
| Provider Name | Kristi M Kindrick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194969584 PECOS PAC ID: 3779727441 Enrollment ID: I20200609002550 |
| Provider Name | Ana Borkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164881108 PECOS PAC ID: 8628492667 Enrollment ID: I20200722003656 |
| Provider Name | Natasha N Patel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841557121 PECOS PAC ID: 5496035354 Enrollment ID: I20200730002578 |
| Provider Name | Kevin Gerard Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669828232 PECOS PAC ID: 4688967326 Enrollment ID: I20201002000960 |
| Provider Name | Nanette Kay Whittington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700302494 PECOS PAC ID: 1355761966 Enrollment ID: I20201021000949 |
| Provider Name | Katheryn Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083262620 PECOS PAC ID: 0345572459 Enrollment ID: I20210311001273 |
| Provider Name | Ryan E Mccallum |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538331137 PECOS PAC ID: 9234559600 Enrollment ID: I20210521002372 |
| Provider Name | Mariah R Curtis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740770536 PECOS PAC ID: 9739430539 Enrollment ID: I20210708001388 |
| Provider Name | Lynn L Bryan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437511730 PECOS PAC ID: 9436551702 Enrollment ID: I20210708002194 |
| Provider Name | Lauren E Clements |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063886331 PECOS PAC ID: 8527362466 Enrollment ID: I20210818000071 |
| Provider Name | Lori Jean Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144554569 PECOS PAC ID: 5193969434 Enrollment ID: I20220505002657 |
| Provider Name | Randal Jordan Shumway |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962027326 PECOS PAC ID: 2264810613 Enrollment ID: I20220526000658 |
| Provider Name | Keith Z Amaral |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417416496 PECOS PAC ID: 0042548018 Enrollment ID: I20220609000491 |
| Provider Name | Curtis a Ellsworth |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750802807 PECOS PAC ID: 9830590785 Enrollment ID: I20220624000002 |
| Provider Name | David B Marble |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841856507 PECOS PAC ID: 7618382169 Enrollment ID: I20220711001789 |
| Provider Name | Muhammad Z Khakwani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710353123 PECOS PAC ID: 5294077244 Enrollment ID: I20220726001526 |
| Provider Name | Sydney Nicole Nielsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609511872 PECOS PAC ID: 2860877487 Enrollment ID: I20220919001650 |
| Provider Name | Brian Michael Wood |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396471348 PECOS PAC ID: 8022487529 Enrollment ID: I20221205002781 |
| Provider Name | Tara Zehmisch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699371385 PECOS PAC ID: 2365813953 Enrollment ID: I20230118001150 |
| Provider Name | Mark Dittenbir |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942249727 PECOS PAC ID: 0749192235 Enrollment ID: I20230419001040 |
| Provider Name | Mark Wasserman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225130933 PECOS PAC ID: 2163411133 Enrollment ID: I20230424001015 |
| Provider Name | Deborah K Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568669489 PECOS PAC ID: 6103960760 Enrollment ID: I20230713003170 |
| Provider Name | Brady T Mannett |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932603032 PECOS PAC ID: 6901134758 Enrollment ID: I20230807001149 |
| Provider Name | Dustin Kyle Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407534316 PECOS PAC ID: 9133583081 Enrollment ID: I20230912001393 |
| Provider Name | Sonya L Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457030991 PECOS PAC ID: 7719331354 Enrollment ID: I20230929002163 |
| Provider Name | Sara Kaye Munns |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811621162 PECOS PAC ID: 4284082249 Enrollment ID: I20231130003691 |
| Provider Name | Vickrey V Kinkade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639268170 PECOS PAC ID: 0749579092 Enrollment ID: I20240108006213 |
| Provider Name | Paul Douglas Young |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407837982 PECOS PAC ID: 0648246264 Enrollment ID: I20240612002069 |
| Provider Name | Lincoln David Hiatt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174147342 PECOS PAC ID: 9537607791 Enrollment ID: I20240819003290 |
| Provider Name | Jason a Park |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184608481 PECOS PAC ID: 9133298649 Enrollment ID: I20240903001752 |
| Provider Name | Vivian T Nguyen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518464783 PECOS PAC ID: 0143578708 Enrollment ID: I20240924001828 |
| Provider Name | Michael J Boyle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245294552 PECOS PAC ID: 3577466549 Enrollment ID: I20241009000885 |
| Provider Name | Gregory S Taylor |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932113743 PECOS PAC ID: 1951301035 Enrollment ID: I20241202001761 |
| Provider Name | Sheridan Lynelle Porter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962224790 PECOS PAC ID: 6709312804 Enrollment ID: I20241212003273 |
| Provider Name | William Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134173800 PECOS PAC ID: 6103820097 Enrollment ID: I20241219001851 |
| Provider Name | Shawnaree Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740289891 PECOS PAC ID: 2769458314 Enrollment ID: I20250217002742 |
| Provider Name | Thomas Brinton |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558593046 PECOS PAC ID: 0547455834 Enrollment ID: I20250318002149 |
| Provider Name | John B Ellsworth |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1083619043 PECOS PAC ID: 2163698648 Enrollment ID: I20250423002760 |
| Provider Name | Aaron J Done |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1467080242 PECOS PAC ID: 3577970565 Enrollment ID: I20250714000493 |
| Provider Name | Elizabeth L Deltoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588431118 PECOS PAC ID: 6507205721 Enrollment ID: I20250828004343 |
| Provider Name | Laura Gibson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1326802786 PECOS PAC ID: 8224470844 Enrollment ID: I20250911003054 |
| Provider Name | Ladawna Rae Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174478952 PECOS PAC ID: 0446728067 Enrollment ID: I20260501001612 |
North Country Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2600 E. Show Low Lake Rd., Show Low, AZ 85901 Phone: 928-537-4300 |
North Country Healthcare, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2650 E. Show Low Lake Rd, Suite 1, Show Low, AZ 85901 Phone: 928-537-4300 Fax: 928-537-4301 |
Brewer Chiropractic LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 581 E Old Linden Rd, Show Low, AZ 85901 Phone: 928-537-2600 Fax: 928-337-3291 |
Steven B. Chintis, D.O., PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5171 Cub Lake Rd, Suite C380, Show Low, AZ 85901 Phone: 928-537-1077 Fax: 928-532-0757 |
Namitha Kishore Bhat Sole Mbr Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2200 E Show Low Lake Rd, Show Low, AZ 85901 Phone: 928-537-6746 |
Elk Ridge Show Low Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2650 E Show Low Lake Rd, Show Low, AZ 85901 Phone: 520-670-3909 Fax: 520-309-2560 |