DHHS IHS Phoenix Area
Organization Active NPI Clinic/Center · Peach Springs, AZ
NPI 1265719934 · NPPES record last updated Dec 12, 2022
Key facts
- NPI
- 1265719934
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- DHHS IHS PHOENIX AREA
- Practice address
- 943 Hualapai Way
Peach Springs, AZ 86434-0190 - Phone
- (928) 769-2900
- Fax
- (928) 769-2701
- NPI assigned
- Nov 9, 2011
- Organization subpart
- No
Authorized official
- Name
- Lisa R Chamberlain
- Title
- Patient Business Office
- Phone
- (928) 769-2918
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 4
Practitioners 211
-
Richard Thomas Greco, D.O.
-
Tina Grinsteiner, APRN-RNP
-
David Lau, DPM
-
Therese McMahan, CNM
-
Lilly Shimahara, DPM
-
Renee Smith, DNP, NP-C
-
Hei Shun Yu, M.D.
-
Julie Ansell, MD
-
Yeu-Shin Cindy Chang, M.D., M.P.H.
-
Keith George Cook, M. D.
-
Kelly Phuong Doan, NURSE PRACTITIONER
-
Susan Willig Fan, M.D.
-
Ayodele T Isaacs, MD
-
Robert Kesead Jr., O.D.
-
Mark Kirane, DO
-
Rishi Patel, M.D.
-
Daniel Jonathan Scher, M.D.
-
Jeffrey A Simon, M.D.
-
Tandace Lorae McDill, M.D.
-
Michael Yeh, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120109000961 | TX | Part B Supplier - Clinic/Group Practice | 7810163011 |
Receives reassigned benefits from 203 practitioners 1 other NPI on this enrollment Practice locations: Peach Springs, AZ; Supai, AZ |
National Provider Directory
- Tax ID family
- Peach Springs Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
943 Hualapai Way
Peach Springs, AZ 86434-0190
Mailing address
PO Box 190
Peach Springs, AZ 86434-0190
Phone (928) 769-2900
Other names
- PEACH SPRINGS HEALTH CENTER
Other providers in Peach Springs, AZ
- William M Brewer
- Roger Orazio Cangialosi
- Alyce Crozier
- Ernestine Alva Crozier
- Amy Elaine Dashee
- DHHS IHS Phoenix Area
- DHHS IHS Phoenix Area
- Deon Eaton
- Gloria C Edreira-Green
- Caroline Hazel Fielding
All providers in Peach Springs, AZ · Clinic/Center in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2022. 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.