OrganizationActive
Ponderosa Pediatricss PLC
NPI 1124243688 · Pediatrics Physician · Prescott, AZ
Ponderosa Pediatricss PLC is a Pediatrics Physician organization in Prescott, AZ (NPI 1124243688).
Provider details
- NPI number
- 1124243688
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Deann Harguess, Credentialing Billing(928) 443-1111
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2120 Centerpointe West Drive
Prescott, AZ 86301
Phone: (928) 443-1111
Fax: (928) 443-5554
Street-level locationGet directions
Mailing address
2120 Centerpointe West Drive
Prescott, AZ 86301
Registry dates
- Enumerated
- 2007-04-17
- Last updated
- 2008-05-15
Frequently asked questions
- What is Ponderosa Pediatricss PLC's NPI number?
- Ponderosa Pediatricss PLC's National Provider Identifier (NPI) is 1124243688, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Ponderosa Pediatricss PLC?
- Ponderosa Pediatricss PLC is classified in the NPPES registry as Pediatrics Physician (Allopathic & Osteopathic Physicians).
- Where is Ponderosa Pediatricss PLC located?
- Ponderosa Pediatricss PLC's practice location on file with NPPES is 2120 Centerpointe West Drive, Prescott, AZ 86301.
- What is Ponderosa Pediatricss PLC's phone number?
- The practice phone number listed in the NPPES registry for Ponderosa Pediatricss PLC is (928) 443-1111.
- Who is the authorized official for Ponderosa Pediatricss PLC?
- The authorized official listed on Ponderosa Pediatricss PLC's NPPES record is Deann Harguess, Credentialing Billing. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Ponderosa Pediatricss PLC's NPI active?
- Yes — Ponderosa Pediatricss PLC's NPI (1124243688) is active in the NPPES registry as of the last update on 2008-05-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.