Fort Mojave Indian Tribe

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

FORT MOJAVE INDIAN TRIBE

Practice address

1607 Plantation Rd
Mohave Valley, AZ 86440-9686

Phone

(928) 346-4679

Fax

(928) 346-4686

NPI assigned

May 16, 2006

Last updated

Feb 6, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Tim Williams

Title

Tribal Chairperson

Phone

(760) 629-4591

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• FORT MOJAVE INDIAN HEALTH CENTER Other name

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1306897962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 PLANTATION RD",
            "city": "MOHAVE VALLEY",
            "state": "AZ",
            "postal_code": "864409686",
            "telephone_number": "928-346-4679",
            "fax_number": "928-346-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 PLANTATION RD",
            "city": "MOHAVE VALLEY",
            "state": "AZ",
            "postal_code": "864409686",
            "telephone_number": "928-346-4679",
            "fax_number": "928-346-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT MOJAVE INDIAN TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "TRIBAL CHAIRPERSON",
        "authorized_official_telephone_number": "760-629-4591",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EAPC",
            "identifier": "EAP00010F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890211",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "0500888779",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FORT MOJAVE INDIAN HEALTH CENTER",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "FORT MOJAVE INDIAN HEALTH CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tammy Marie Comfort, RDH
• Elite Medical Transport Service LLC
• Heidi Fey
• Fort Mojave Health Center Pharmacy
• Fort Mojave Indian Tribe
• Fort Mojave Indian Tribe
• Julia S Goodwin, MPT
• Ann M Guimond, CCC-SLP
• Sheila Ann Halbert, COUMSELOR
• Cynthia Lenette Harper, NP

• Rural Health Clinic/Center in Mohave Valley, AZ
• Providers in Mohave Valley, AZ by specialty
• Rural Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.