NPIMap

Organization Active NPI

DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Sanostee, NM
National Provider Identifier
1083839476
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
DHHS, PHS, NAIHS, SHIPROCK HOSPITAL
Practice address
Navajo Route 34
Sanostee, NM 87461
Phone
(505) 368-6001
Fax
(505) 368-6431
NPI assigned
Apr 13, 2007
Last updated
Jul 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Fannessa Comer
Title
Ceo
Phone
(505) 368-6006

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Community Health Clinic/Center 261QC1500X NU
Non-Surgical Family Planning Clinic/Center 261QF0050X NU
Student Health Clinic/Center 261QS1000X NU
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

Navajo Route 34
Sanostee, NM 87461

Mailing address

In Care of Northern Navajo Medical Center
PO Box 160
Shiprock, NM 87420
Phone (505) 368-6001

Other identifiers 1

IdentifierTypeStateIssuer
96174056MedicaidNM

Other names 1

  • Sanostee Health Station Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000809 TX Part B Supplier - Clinic/Group Practice 0749193837 Receives reassigned benefits from 616 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomfield, NM; Toadlena, NM; Teecnospos, AZ; Sanostee, NM; Shiprock, NM
O20100830000949 NM Part A Provider - Hospital 0749193837 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomfield, NM; Sanostee, NM; Shiprock, NM; Teecnospos, AZ; Toadlena, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083839476. Details of each certification follow.

Hospital certification: CCN 320059

Legal name
DHHS PHS NAIHS SHIPROCK HOSPITAL
Doing business as
NORTHERN NAVAJO MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Mar 18, 1977
Last certification
Aug 17, 1987
Beds
69
Ownership / control type
Federal
Organization structure
OtherNon-profit
Enrollment address
Hwy 491 North
Shiprock, NM 87420-9998
Other Hospital Practice Location
Hospital subgroups
Acute care, Other

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Northern Navajo Medical CenterCCN 320059 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Federal
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
DHHS PHS Naihs Shiprock Hospital Organization, Shiprock, NM Operational/Managerial Control Jul 1, 2010
DHHS PHS Navajo Area Indian Health Service Organization, St. Michael, AZ Operational/Managerial Control Jul 1, 2010
Katrina Leslie-Puhuyaoma Individual Corporate OfficerChief Executive Officer Aug 5, 2024
Robina Harvey Individual Corporate OfficerHealth System Administrator Aug 5, 2024
Tanya Deale Individual W-2 Managing EmployeeActing Business Office Manager Nov 9, 2021

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

Affiliated clinicians 139

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 139

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1083839476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "IN CARE OF NORTHERN NAVAJO MEDICAL CENTER",
            "address_2": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAJO ROUTE 34",
            "city": "SANOSTEE",
            "state": "NM",
            "postal_code": "87461",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS, PHS, NAIHS, SHIPROCK HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "COMER",
        "authorized_official_first_name": "FANNESSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-368-6006"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96174056",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanostee Health Station",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Sources for this page

Verify at the official NPI Registry.