Peach Springs Indian Health Center

Primary specialty

Federal Public Health Clinic/CenterTaxonomy code 261QP0904X

License

RN167054 Issued in AZ

Legal business name

PEACH SPRINGS INDIAN HEALTH CENTER

Practice address

943 Hualapai Way
Peach Springs, AZ 86434-0190

Phone

(928) 769-2900

NPI assigned

May 25, 2012

Last updated

May 25, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

DHHSAs reported in NPPES

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

Authorized official

Name

Randi Lynn Wood, R.N

Title

Clinical Nurse

Phone

(928) 699-8879

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1023378825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 HUALAPAI WAY",
            "city": "PEACH SPRINGS",
            "state": "AZ",
            "postal_code": "864340190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 HUALAPAI WAY",
            "city": "PEACH SPRINGS",
            "state": "AZ",
            "postal_code": "864340190",
            "telephone_number": "928-769-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH SPRINGS INDIAN HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DHHS",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CLINICAL NURSE",
        "authorized_official_telephone_number": "928-699-8879",
        "authorized_official_credential": "R.N"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": "AZ",
            "license": "RN167054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie McGuire, RN
• Scott H Myers, PHARMD
• Donald Bruce Niebel, MD
• Julia G. O'Brien, RN
• Peach Springs Health Center
• Peach Springs Unified School District #8 (Psusd #8)
• Vernie Phillips Jr., LMSW, LISAC
• Rebecca Ann Rice
• Melissa Kay Scott, RN
• Claudia J Shultz, RN

• Clinic/Center in Peach Springs, AZ
• Providers in Peach Springs, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.