KIRBY FARNSWORTH D.O.
Complete NPI Record 1124464839
Emergency Medicine in Wickenburg, AZ

Active since May 21, 2013PECOS EnrolledAccepts Medicare Assignment
520 ROSE LN, WICKENBURG, AZ 85390(928) 668-1803(928) 684-2434 Get Directions

NPPES record last updated: April 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 26, 2024, Aug 20, 2019, Nov 9, 2016 and 2 more (5 updates tracked since 2016).

Complete NPI Dataset

This page contains the complete raw NPPES record for Kirby Farnsworth, D.O. (NPI 1124464839), an individual emergency medicine provider in Wickenburg, AZ. All 34 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1124464839
Field 1/34
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Field 2/34
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal Name: FARNSWORTH
Field 3/34
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: KIRBY
Field 4/34
The first name of the provider, if the provider is an individual.
Provider Credential Text: D.O.
Field 5/34
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 20470 N LAKE PLEASANT RD STE 109
Field 6/34
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: PEORIA
Field 7/34
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: AZ
Field 8/34
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 853829708
Field 9/34
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 10/34
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 6234042244
Field 11/34
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 6234042245
Field 12/34
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 520 ROSE LN
Field 13/34
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: WICKENBURG
Field 14/34
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: AZ
Field 15/34
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 853901447
Field 16/34
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 17/34
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9286681803
Field 18/34
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 9286842434
Field 19/34
The fax number associated with the location address of the provider being identified.
Provider Gender Code: M
Field 22/34
The code designating the provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 207Q00000X
Field 23/34
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 006965
Field 24/34
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 1: AZ
Field 25/34
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: N
Field 26/34
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 2: 390200000X
Field 27/34
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 2: N
Field 28/34
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 3: 207P00000X
Field 29/34
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 3: Q1981
Field 30/34
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 3: TX
Field 31/34
The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 3: Y
Field 32/34
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Sole Proprietor: Y
Field 33/34
Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.

Secondary Practice Locations 1

The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.

20470 N Lake Pleasant Rd Ste 109
Location 1/1
Peoria, AZ 85382-9708 · Phone (623) 404-2244 · Fax (623) 404-2245
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