NPIMap

Organization Active NPI

Bethel Hills Integrated Healthcare

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1215698642
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
BETHEL HILLS INTEGRATED HEALTHCARE
Practice address
13838 S 46TH PL Ste 340
Phoenix, AZ 85044-7805
Phone
(480) 597-7903
Fax
(480) 597-7903
NPI assigned
Jan 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Authorized official

Name
Olubukola Komolafe, DNPNPI 1134628738
Title
Medical Director
Phone
(832) 542-3181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Clinic/Center 261Q00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Multi-Specialty Clinic/Center 261QM1300X Primary
Primary Care Clinic/Center 261QP2300X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

13838 S 46TH PL Ste 340
Phoenix, AZ 85044-7805

Mailing address

13838 S 46TH PL Ste 340
Phoenix, AZ 85044-7805
Phone (480) 597-7903

Other practice location 1

6150 Transverse Dr Ste 103
Las Vegas, NV 89146-1170
Phone (702) 530-4531

Other names 1

  • Bethel Hills Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address admin@bethelhillsintegrated.com

National Provider Directory

National Provider Directory
Tax ID family
Bethel Hills Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

13838 S 46th Pl
Ste 340
Phoenix, AZ 85044
Phone (480) 597-7903

6150 Transverse Dr
Ste 103
Las Vegas, NV 89146
Phone (702) 530-4531

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": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1215698642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL STE 340",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447805",
            "telephone_number": "480-597-7903",
            "fax_number": "480-597-7903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL STE 340",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447805",
            "telephone_number": "480-597-7903",
            "fax_number": "480-597-7903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6150 Transverse Dr Ste 103",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891461170",
            "country_code": "US",
            "telephone_number": "702-530-4531",
            "fax_number": "702-660-7123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BETHEL HILLS INTEGRATED HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "KOMOLAFE",
        "authorized_official_first_name": "OLUBUKOLA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "832-542-3181",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@bethelhillsintegrated.com",
            "affiliation": "N",
            "address_1": "13838 S 46th Pl Ste 340",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850447805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Bethel Hills Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.