NPIMap

Organization Active NPI

PHC-Fort Mohave, Inc.

Doing business as Crossroads Urgent Care by Valley View Medical Center

  • Urgent Care Clinic/Center
  • Bullhead City, AZ
National Provider Identifier
1174955116
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PHC-FORT MOHAVE, INC.
Doing business as
Crossroads Urgent Care by Valley View Medical Center
Practice address
3641 Highway 95
Bullhead City, AZ 86442-8151
Phone
(928) 758-2273
Fax
(928) 758-2166
NPI assigned
Aug 1, 2013
Last updated
Aug 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Authorized official

Name
Donald J. Bivacca
Title
President
Phone
(615) 372-8500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

3641 Highway 95
Bullhead City, AZ 86442-8151

Mailing address

103 Powell CT
Brentwood, TN 37027-5079
Phone (615) 372-8500

Other names 1

  • Crossroads Urgent Care by Valley View Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
PHC-Fort Mohave Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1174955116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 POWELL CT",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275079",
            "telephone_number": "615-372-8500",
            "fax_number": "615-372-8572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 HIGHWAY 95",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428151",
            "telephone_number": "928-758-2273",
            "fax_number": "928-758-2166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC-FORT MOHAVE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "BIVACCA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-372-8500"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Urgent Care by Valley View Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.