NPIMap

Organization Active NPI

Changepoint Integrated Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holbrook, AZ
National Provider Identifier
1205877610
Registry record updated Sep 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
OTC6041 Issued in AZ
Legal business name
CHANGEPOINT INTEGRATED HEALTH
Practice address
103 N 1St Ave
Holbrook, AZ 86025-2817
Phone
(928) 537-2951
Fax
(928) 892-5828
NPI assigned
Jun 8, 2006
Last updated
Sep 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2022

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

Authorized official

Name
Mr. Jeffrey Oakes, MBA
Title
Chief Executive Officer
Phone
(928) 537-2951

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X OTC6041 AZ Primary

Addresses

Primary practice location

103 N 1St Ave
Holbrook, AZ 86025-2817

Mailing address

1801 W Deuce of Clubs Ste 100
Show Low, AZ 85901-2704
Phone (928) 537-2951

Other identifiers 1

IdentifierTypeStateIssuer
003450OtherAZAHCCCS

Other names 1

  • Community Counseling Centers, Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625001074 AZ Part B Supplier - Clinic/Group Practice 8123004587 Receives reassigned benefits from 36 practitioners
10 other NPIs on this enrollment
Practice locations: Winslow, AZ; Snowflake, AZ; Pinetop, AZ; Show Low, AZ; Holbrook, AZ; Lakeside, AZ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory

Locations

103 N 1st Ave
Holbrook, AZ 86025
Phone 9285246126 ext. 3325

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662249600000",
    "number": "1205877610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W DEUCE OF CLUBS STE 100",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859012704",
            "telephone_number": "928-537-2951",
            "fax_number": "928-892-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N 1ST AVE",
            "city": "HOLBROOK",
            "state": "AZ",
            "postal_code": "860252817",
            "telephone_number": "928-537-2951",
            "fax_number": "928-892-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGEPOINT INTEGRATED HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2022-09-04",
        "certification_date": "2022-09-04",
        "status": "A",
        "authorized_official_last_name": "OAKES",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "928-537-2951",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AZ",
            "license": "OTC6041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "003450",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Counseling Centers, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Holbrook, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.