NPIMap

Organization Active NPI

Los Ninos Hospital Inc.

Doing business as Los Ninos Hospital

  • Special Hospital
  • Phoenix, AZ
National Provider Identifier
1235226440
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
SHO188 Issued in AZ
Legal business name
LOS NINOS HOSPITAL INC.
Doing business as
Los Ninos Hospital
Practice address
2303 E. Thomas Rd
Phoenix, AZ 85016
Phone
(902) 954-7311
Fax
(902) 954-7355
NPI assigned
Oct 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dale Norman Skurdahl
Title
Chief Operating Officer-M.S.
Phone
(602) 243-4231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X SHO188 AZ Primary

Addresses

Primary practice location

2303 E. Thomas Rd
Phoenix, AZ 85016

Mailing address

1402 E. South Mountain Avenue
Phoenix, AZ 85042
Phone (602) 243-4231

Other identifiers 3

IdentifierTypeStateIssuer
0D0898997OtherAZCLIA WAIVER
155128MedicaidAZ
SHO188OtherAZSTATE LICENSE

Other names 1

  • Los Ninos Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235226440. Details of each certification follow.

Hospital certification: CCN 033301

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LOS NINOS HOSPITAL, INC.
Certification status
Terminated Voluntary: merger or closure, Sep 30, 2017
Provider type (POS)
Hospital – Children’s
Participating since
Apr 14, 1994
Last certification
Jun 5, 2015
Beds
15
Ownership / control type
Private (not for profit)
Facility address
2303 East Thomas
Phoenix, AZ 85016

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235226440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 E. SOUTH MOUNTAIN AVENUE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85042",
            "telephone_number": "602-243-4231",
            "fax_number": "602-323-5988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 E. THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85016",
            "telephone_number": "902-954-7311",
            "fax_number": "902-954-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS NINOS HOSPITAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SKURDAHL",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "NORMAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER-M.S.",
        "authorized_official_telephone_number": "602-243-4231"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "AZ",
            "license": "SHO188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "0D0898997",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155128",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SHO188",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Los Ninos Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.