Heart Shop, LLC
NPI 1558997742ActiveOrganization· Internal Medicine, Cardiovascular Disease· Prescott, AZ
Internal Medicine, Cardiovascular Disease in Prescott, Arizona, registered in NPPES in March 2020. The authorized official on file is Douglas Wayne Rothrock, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1558997742 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 19, 2020 |
| Last updated in NPPES | May 19, 2020 |
| Certified by provider | May 19, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine, Cardiovascular Disease Primary | 207RC0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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