Individual provider Active NPI

Cynthia Dah, DNP-FNP-C, RN

  • Family Nurse Practitioner
  • Shonto, AZ
National Provider Identifier
1144613308
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
55771 Issued in NM
Practice address
Hwy 98 Navajo Route 16
Shonto, AZ 86054
Phone
(928) 672-3000
NPI assigned
Mar 12, 2015
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704261309 MI
Family Nurse Practitioner 363LF0000X 55771 NM Primary
Registered Nurse 163W00000X 782837 CA
Registered Nurse 163W00000X 4704261309 MI
Registered Nurse 163W00000X 613142 NY
Registered Nurse 163W00000X 041416245 IL
Registered Nurse 163W00000X 55771 NM
Registered Nurse 163W00000X 224123 AK

Addresses

Primary practice location

Hwy 98 Navajo Route 16
Shonto, AZ 86054

Mailing address

317 N Harrison St
Berrien Springs, MI 49103-1004
Phone (269) 815-0330

Other practice location 1

317 N Harrison St
Berrien Springs, MI 49103-1004
Phone (269) 815-0330

Other identifiers 1

IdentifierTypeStateIssuer
020529MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241111003667 TX Practitioner - Nurse Practitioner 4486188604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
224123AKMDRegistered Nurse
782837CAMDRegistered Nurse
041416245ILMDRegistered Nurse
613142NYMDRegistered Nurse
4704261309MIMDFamily Nurse Practitioner
55771NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kayenta Alternative Rural Hospital CurrentSince Sep 8, 2024 Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Sep 8, 2024 Accepting new patients
Kayenta Alternative Rural Hospital Current Accepting new patients
Kayenta Alternative Rural Hospital CurrentSince Sep 8, 2024 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1144613308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N HARRISON ST",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031004",
            "telephone_number": "269-815-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HWY 98 NAVAJO ROUTE 16",
            "city": "SHONTO",
            "state": "AZ",
            "postal_code": "86054",
            "telephone_number": "928-672-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 N Harrison St",
            "address_purpose": "LOCATION",
            "city": "Berrien Springs",
            "state": "MI",
            "postal_code": "491031004",
            "country_code": "US",
            "telephone_number": "269-815-0330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAH",
        "first_name": "CYNTHIA",
        "name_prefix": "Dr.",
        "credential": "DNP-FNP-C, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704261309",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "55771",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "782837",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704261309",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "613142",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041416245",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "55771",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "224123",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020529",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shonto, AZ

Sources for this page

Verify at the official NPI Registry.