NPIMap

Organization Active NPI

Chemehuevi Indian Tribe

  • Clinic/Center
  • Havasu Lake, CA
National Provider Identifier
1144910753
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CHEMEHUEVI INDIAN TRIBE
Practice address
1970 Palo Verde Drive
Havasu Lake, CA 92363-1976
Phone
(760) 858-5426
NPI assigned
May 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Authorized official

Name
Glenn Lodge
Title
Tribal Chairman
Phone
(760) 858-4219

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1970 Palo Verde Drive
Havasu Lake, CA 92363-1976

Mailing address

PO Box 1976
Havasu Lake, CA 92363-1976
Phone (760) 858-4219

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1144910753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1976",
            "city": "HAVASU LAKE",
            "state": "CA",
            "postal_code": "923631976",
            "telephone_number": "760-858-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 PALO VERDE DRIVE",
            "city": "HAVASU LAKE",
            "state": "CA",
            "postal_code": "923631976",
            "telephone_number": "760-858-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEMEHUEVI INDIAN TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "LODGE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "TRIBAL CHAIRMAN",
        "authorized_official_telephone_number": "760-858-4219"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havasu Lake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.