Organization Active NPI

Community Medical Services Arizona-Private, LLC

Doing business as Community Medical Services Prescott Valley

  • Methadone Clinic
  • Prescott Valley, AZ
National Provider Identifier
1215648951
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC
Doing business as
Community Medical Services Prescott Valley
Practice address
3155 N Windsong Dr Ste a
Prescott Valley, AZ 86314-2219
Phone
(928) 968-7400
Fax
(480) 687-7361
NPI assigned
Dec 13, 2022
Last updated
Feb 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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

Authorized official

Name
Cindy Gaither
Title
VP of Revenue Cycle Management
Phone
(602) 248-8886

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Methadone Clinic 261QM2800X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

3155 N Windsong Dr Ste a
Prescott Valley, AZ 86314-2219

Mailing address

8444 N 90TH St Ste 100
Scottsdale, AZ 85258-4437
Phone (602) 248-8886

Other names 1

  • Community Medical Services Prescott Valley Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2237642Community Medical Services - Prescott Valley3155 N Windsong Dr Ste a, Prescott Valley, AZ 86314Certificate of waiverSep 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Medical Services Arizona-Private LLC36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

Locations

3155 N Windsong Dr
Ste A
Prescott Valley, AZ 86314
Phone (928) 968-7400

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707523200000",
    "number": "1215648951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 N 90TH ST STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584437",
            "telephone_number": "602-248-8886",
            "fax_number": "480-687-7361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 N WINDSONG DR STE A",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142219",
            "telephone_number": "928-968-7400",
            "fax_number": "480-687-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL SERVICES ARIZONA-PRIVATE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-13",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A",
        "authorized_official_last_name": "GAITHER",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "602-248-8886"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Medical Services Prescott Valley",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Medical Services Prescott Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.