Organization Active NPI

Family Healthcare of Yuma

  • Family Nurse Practitioner
  • Yuma, AZ
National Provider Identifier
1255011920
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
FAMILY HEALTHCARE OF YUMA
Practice address
2589 E 24TH St Ste 2
Yuma, AZ 85365-3226
Phone
(928) 275-3213
Fax
(928) 268-0148
NPI assigned
Jul 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Amy Lauren WoodmanNPI 1225713654
Title
Manager
Phone
(307) 258-2207

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2589 E 24TH St Ste 2
Yuma, AZ 85365-3226

Mailing address

2946 S Avenue B
Yuma, AZ 85364-7704
Phone (928) 275-3213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240816002558 AZ Part B Supplier - Clinic/Group Practice 1052859386 Receives reassigned benefits from 2 practitioners
Practice locations: Yuma, AZ

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
03D2302675Family Healthcare of Yuma2589 E 24TH Ste 2, Yuma, AZ 85365Certificate of waiverApr 14, 2028

National Provider Directory

National Provider Directory

Locations

2589 E 24th St
Yuma, AZ 85365

Practitioners & affiliated clinicians

Practitioners 2

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": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1255011920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 S AVENUE B",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647704",
            "telephone_number": "928-275-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2589 E 24TH ST STE 2",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853653226",
            "telephone_number": "928-275-3213",
            "fax_number": "928-268-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTHCARE OF YUMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "WOODMAN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "LAUREN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "307-258-2207"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.