NPIMap

Organization Active NPI

Marana Teen Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
National Provider Identifier
1104143411
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
OTC0819 Issued in AZ
Legal business name
MARANA TEEN WELLNESS CENTER
Practice address
12000 W Emigh Rd
Tucson, AZ 85743-9696
Phone
(520) 682-9128
Fax
(520) 682-9136
NPI assigned
Apr 26, 2010
Organization subpart
Yes
Parent organization
MARANA HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Authorized official

Name
DD Sande
Title
Credentialing Specialist
Phone
(520) 682-4560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X OTC0819 AZ Primary

Addresses

Primary practice location

12000 W Emigh Rd
Tucson, AZ 85743-9696

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4560

National Provider Directory

National Provider Directory
Tax ID family
Marana Health Center Inc42 organizations share this tax ID, including this one
Part of
Marana Health Center Inc

Other organizations with this tax ID 41

Organizations that report the same tax identification number in the National Provider Directory.

View all 41

Locations

12000 W Emigh Rd
Tucson, AZ 85743
Phone (520) 616-6400

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/32652/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1104143411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4560",
            "fax_number": "520-682-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 W EMIGH RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857439696",
            "telephone_number": "520-682-9128",
            "fax_number": "520-682-9136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARANA TEEN WELLNESS CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARANA HEALTH CENTER",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "SANDE",
        "authorized_official_first_name": "DD",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "520-682-4560"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AZ",
            "license": "OTC0819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.