Mohave Family Healthcare

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3527 Issued in AZ

Legal business name

MOHAVE FAMILY HEALTHCARE

Practice address

1611 E Joy LN
Fort Mohave, AZ 86426-8807

Phone

(928) 768-9496

Fax

(928) 768-1943

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William Brian WomackNPI 1679678205

Title

D.O./Owner

Phone

(928) 768-9496

Specialties & licenses 1

Addresses

Other names 1

• Mohave Family Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CIAHCD

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Brian Womack, D.O.

  • Family Medicine Physician
  • Fort Mohave, AZ
  • NPI 1679678205

  AZ, Family Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Larry Lee Bousquet II, FNP

  • Nurse Practitioner
  • Fort Mohave, AZ
  • NPI 1205544871

  AZ

  Medicare reassignment Care Compare group NPD
• Diana McNally, FNP

  • Family Nurse Practitioner
  • Bullhead City, AZ
  • NPI 1144740036

  AZ

  Medicare reassignment Care Compare group NPD
• Thomas Glenn Belt II, PA-C

  • Medical Physician Assistant
  • Mohave Valley, AZ
  • NPI 1669531984

  AZ

  Medicare reassignment Care Compare group
• Jenny Lynn Parker, NP-C

  • Family Nurse Practitioner
  • Benton Harbor, MI
  • NPI 1184102097

  AZ

  Medicare reassignment NPD
• Lisa Jane Carpenter, P.A.C.

  • Physician Assistant
  • Fort Mohave, AZ
  • NPI 1639126063

  AZ

  Medicare reassignment

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554422400000",
    "number": "1043369168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9479",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864279479",
            "telephone_number": "928-768-9496",
            "fax_number": "928-768-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 E JOY LN",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864268807",
            "telephone_number": "928-768-9496",
            "fax_number": "928-768-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAVE FAMILY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2019-04-05",
        "status": "A",
        "authorized_official_last_name": "WOMACK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "D.O./OWNER",
        "authorized_official_telephone_number": "928-768-9496",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mohave Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medstat Anesthesia Consultants
• Francisco J. Melo, MD
• Rhenand Mendoza, PT, DPT
• Michael G Valpiani MD Az LTD
• Mohave Desert Radiology PLC
• Mohave Hearing LLC
• Mohave Neuro Rehab Consul PC
• Mohave Pharmacy L.L.C.
• Mohave Sleep Medicine Associates LLC
• Mohave Valley Elem. School District

• All providers in Fort Mohave, AZ
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.