NPIMap

DHHS PHS Naihs Crownpoint Hospital

Organization Active NPI General Acute Care Hospital · Crownpoint, NM

NPI 1114960093 · NPPES record last updated Oct 18, 2012

Key facts

NPI
1114960093
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
Legal business name
DHHS PHS NAIHS CROWNPOINT HOSPITAL
Practice address
Junction of Hwy 371
Navajo RT9
Crownpoint, NM 87313-0358
Phone
(505) 786-5291
Fax
(505) 786-6440
NPI assigned
Jun 14, 2006
Organization subpart
No

Authorized official

Name
Mr. Anslem Roanhorse
Title
Ceo
Phone
(505) 786-5291

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 2

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

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners 272

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

View all 272

Affiliated clinicians 46

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

View all 46

Medicare Care Compare: Hospital

Listed as
Crownpoint Healthcare Facility CCN 320062
Type
Acute Care Hospitals
Ownership
Government - Federal
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in TX, NM

Hospital certification: CCN 320062

Legal name
DHHS PHS NAIHS CROWNPOINT HOSPITAL
Doing business as
CROWNPOINT HEALTHCARE FACILITY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Mar 21, 1977
Last certification
Sep 22, 2023
Beds
20
Ownership / control type
Federal
Organization structure
Other · Proprietary
Incorporated
Dec 21, 1992 in NM
Enrollment address
Junction of Hwy 371 Navajo RT 9
Crownpoint, NM 87313-0358
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 3

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 Crownpoint Hospital
Organization · Crownpoint, NM 		Operational/Managerial Control Jul 1, 1976
Daryl Dineyazhe-Toya
Individual 		Corporate Officer Jul 15, 2022
Corporate Director Jul 15, 2022
Orlando Johnson
Individual 		Corporate Director Jan 30, 2023
W-2 Managing Employee Jan 30, 2023

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20031230000393 TX Part B Supplier - Clinic/Group Practice 0143128041 Receives reassigned benefits from 267 practitioners
2 other NPIs on this enrollment
Practice locations: Crownpoint, NM; Cuba, NM; Thoreau, NM
O20120112000511 NM Part a Provider - Hospital 0143128041 2 other NPIs on this enrollment
Practice locations: Crownpoint, NM; Cuba, NM; Thoreau, NM

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Yes

Addresses

Primary practice location

Junction of Hwy 371
Navajo RT9
Crownpoint, NM 87313-0358

Mailing address

PO Box 358
Crownpoint, NM 87313-0358
Phone (505) 786-5291

Other identifiers

IdentifierTypeStateIssuer
H8906MedicaidNM
32U062OtherNMMEDICARE SWINGBED
HSZ143OtherNMMEDICARE GROUP PTAN

Other names

  • Crownpoint IHS Other name

Other providers in Crownpoint, NM

All providers in Crownpoint, NM · General Acute Care Hospital in New Mexico

Sources for this page

Verify at the official NPI Registry.