NPIMap

Dignity Health

Organization Active NPI Emergency Care Clinic/Center · Litchfield Park, AZ

NPI 1265065445 · NPPES record last updated Feb 17, 2020

Key facts

NPI
1265065445
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Care Clinic/Center 261QE0002X
Legal business name
DIGNITY HEALTH
Practice address
4975 N Dysart Rd Ste 100
Litchfield Park, AZ 85340-3087
Phone
(602) 406-8700
Fax
(602) 406-8870
NPI assigned
Feb 17, 2020
Organization subpart
Yes
Parent organization (as reported)
DIGNITY HEALTH

Authorized official

Name
Jeffrey Jackson
Title
Chief Financial Officer
Phone
(602) 406-4618

Other NPIs on the same Medicare enrollment 3

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

Corporate family (same tax ID) 12

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

Facilities connected through Provider of Services related, parent or unit certification numbers.

Affiliated clinicians 938

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 938

Medicare Care Compare: Hospital

Listed as
St Josephs Hospital and Medical Center CCN 030024
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2182029Dignity Health St Joseph'S Hospital & Medical
4975 N Dysart Rd Suite 100, Litchfield Park, AZ 85340		AccreditationAug 31, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ

Hospital certification: CCN 030024

Legal name
DIGNITY HEALTH
Doing business as
ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 16, 2016
Beds
586
Ownership / control type
Church
Organization structure
Corporation · Non-profit
Incorporated
Oct 11, 1954 in CA
Enrollment address
350 W Thomas Rd
Phoenix, AZ 85013-4409
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Other

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marvin O'Quinn
Individual 		Corporate Officer
President/Chair		 Feb 1, 2019
Corporate Director
President/Chair		 Jan 27, 2021
Commonspirit Health
Organization · Chicago, IL
Corporation, Non-profit 		5% Or Greater Indirect Ownership Interest Feb 1, 2019 100%
Operational/Managerial Control Feb 1, 2019
Scott Carswell
Individual 		Corporate Director
Board Member		 Jan 27, 2021
Dignity Health
Organization · San Francisco, CA
Corporation, Non-profit 		5% Or Greater Direct Ownership Interest Dec 12, 1986 100%
Daniel Morissette
Individual 		Corporate Officer
Sevp/Chief Financial Officer		 Feb 1, 2019
Mitch Melfi
Individual 		Corporate Officer
Vice Chair & Secretary		 Jan 27, 2021
Corporate Director
Board Member		 Jan 27, 2021
Elizabeth Shih
Individual 		Corporate Officer
Asst Secretary		 Jan 27, 2021
Corporate Director
Board Member		 Jan 27, 2021
Steven W Scharmann
Individual 		Corporate Officer
Administrator of Payor Programs		 Nov 14, 2022
Operational/Managerial Control
VP, Finance and Rev Cycle		 Feb 1, 2019
John E Petersdorf
Individual 		Corporate Officer
Administrator of Payor Programs		 Nov 14, 2022
Operational/Managerial Control
SVP/Operations Finance		 Feb 1, 2019

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070801000387 AZ Part a Provider - Hospital 2062320559 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Glendale, AZ; Litchfield Park, AZ

National Provider Directory

Tax ID family
Catholic Healthcare West (74 organizations share this tax ID)
Part of
Catholic Healthcare West

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Yes

Addresses

Primary practice location

4975 N Dysart Rd Ste 100
Litchfield Park, AZ 85340-3087

Mailing address

4975 N Dysart Rd Ste 100
Litchfield Park, AZ 85340-3087

Other names

  • St. Josephs Hospital and Medical Center Emergency Dept-Litchfield Park Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 17, 2020.

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1265065445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4975 N DYSART RD STE 100",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4975 N DYSART RD STE 100",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403087",
            "telephone_number": "602-406-8700",
            "fax_number": "602-406-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIGNITY HEALTH",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "602-406-4618"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Josephs Hospital and Medical Center Emergency Dept-Litchfield Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Litchfield Park, AZ

All providers in Litchfield Park, AZ · Emergency Care Clinic/Center in Arizona

Sources for this page

Verify at the official NPI Registry.