DHHS PHS IHS Phoenix Area
Organization Active NPI Clinic/Center · Winterhaven, CA
NPI 1265719918 · NPPES record last updated Feb 15, 2023
Key facts
- NPI
- 1265719918
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- DHHS PHS IHS PHOENIX AREA
- Practice address
- 401 Picacho Road
Winterhaven, CA 92283 - Phone
- (760) 572-4100
- Fax
- (760) 572-2133
- NPI assigned
- Nov 9, 2011
- Organization subpart
- No
Authorized official
- Name
- Tricia Chamberlain
- Title
- Chief Executive Officer
- Phone
- (760) 572-4100
Corporate family (same tax ID) 3
Practitioners 58
-
Salvador Aquino, LPC-17281
-
Kevin Vincent Kohler, M.D.
-
Eunis Bello, DPM
-
Ashley Ann Davis, DPT
-
Martha A Dodson, D.O.
-
Tina Grinsteiner, APRN-RNP
-
Shannon L Hughes, CRNP
-
Catherine Lamboley, RDN
-
Leona Marie Martin, M.D.
-
Sandy Nguyen, DPM
-
Scott Peake, NP
-
Matthew Pettengill, DPM
-
Manuel A. Reyes, M.D.
-
Andrew James Terranella, MD, MPH
-
Macarthur E. Lucio, LISW
-
Lee Ryder, DPT
-
Bernaliza Laban Arce, M.D.
-
Arthur Anthony Blain IV, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111212000142 | TX | Part B Supplier - Clinic/Group Practice | 2668647108 |
Receives reassigned benefits from 58 practitioners Practice locations: Winterhaven, CA |
National Provider Directory
- Tax ID family
- DHHS PHS IHS Phoenix Area
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
401 Picacho Road
Winterhaven, CA 92283
Mailing address
PO Box 1368
Yuma, AZ 85366-2361
Phone (760) 572-4100
Other names
- FT YUMA INDIAN HEALTH CENTER
Other providers in Winterhaven, CA
- Beth Cleavenger
- Clinicas de Salud del Pueblo, Inc.
- M. Elizabeth Smith Daniel
- Mary Decorse
- Sally Ann Decorse
- DHHS PHS IHS Phoenix Area
- DHHS PHS IHS Phoenix Area
- DHHS PHS IHS Phoenix Area
- Deborah Ann Drumel
- Nancy Jo Edwards
All providers in Winterhaven, CA · Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.