NPIMap

Individual provider Active NPI

Christopher K Jentoft, M.D.

  • Family Medicine Physician
  • Whiteriver, AZ
National Provider Identifier
1003040940
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
44352 Issued in AZ
Practice address
200 West Hospital Drive
Whiteriver, AZ 85941-0860
Phone
(928) 338-4911
Fax
(928) 338-3520
NPI assigned
May 6, 2009
Last updated
Feb 11, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44352 AZ Primary

Addresses

Primary practice location

200 West Hospital Drive
Whiteriver, AZ 85941-0860

Mailing address

520 Rose LN
200 West Hospital Drive
Wickenburg, AZ 85390-1447
Phone (928) 668-1811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130126000003 TX Practitioner - Family Practice 5698929750 Reassigns benefits to 5 organizations
I20160212002440 AZ Practitioner - Family PracticePractitioner - Emergency Medicine 5698929750 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS IHS Phoenix AreaGroup PAC ID 2668649567, 72 clinicians

Practice addresses (Care Compare)

200 W Hospital Dr
Whiteriver, AZ 85941-0860
Phone 92833849113532

N Cromwell Rd
Cibecue Health Ctr
Cebecue, AZ 85911-0037
Phone 92833849113532

PO Box
Suite 860
Whiteriver, AZ 85941-0860

State Hwy 264 JCT Hwy 191
Ganado, AZ 86505-0457
Phone 92875545004933

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS IHS Phoenix Area CurrentSince Jun 22, 2022 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince May 15, 2018 Accepting new patients
DHHS IHS Phoenix Area Family Medicine CurrentSince Dec 25, 2019 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Sep 15, 2022 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince May 15, 2018 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Oct 20, 2012 Accepting new patients
DHHS IHS Phoenix Area CurrentSince Oct 20, 2012 Accepting new patients
Hospitalist Medicine Healthcare LLC CurrentSince May 1, 2018 Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

401 Picacho Rd
Winterhaven, CA 92283
Phone (760) 572-4100

4100 W 150th St
Cleveland, OH 44135

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1003040940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 ROSE LN",
            "address_2": "200 WEST HOSPITAL DRIVE",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901447",
            "telephone_number": "928-668-1811",
            "fax_number": "928-684-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WEST HOSPITAL DRIVE",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "859410860",
            "telephone_number": "928-338-4911",
            "fax_number": "928-338-3520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENTOFT",
        "first_name": "CHRISTOPHER",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-06",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "44352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteriver, AZ

Sources for this page

Verify at the official NPI Registry.