NPIMap

Organization Active NPI

DHHS IHS Phoenix Area

Doing business as Hopi Health Care Center

  • Critical Access Hospital
  • Polacca, AZ
National Provider Identifier
1356628028
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
366937 Issued in AZ
Legal business name
DHHS IHS PHOENIX AREA
Doing business as
Hopi Health Care Center
Practice address
Highway 264 Milepost 388
Polacca, AZ 86042-4000
Phone
(928) 737-6000
Fax
(928) 737-6080
NPI assigned
Nov 9, 2011
Last updated
May 24, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Authorized official

Name
Daryl Melvin
Title
Ceo
Phone
(928) 737-6010

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Critical Access Hospital 282NC0060X 366937 AZ Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364S00000X

Addresses

Primary practice location

Highway 264 Milepost 388
Polacca, AZ 86042-4000

Mailing address

Highway 264 Milepost 388
PO Box 4000
Polacca, AZ 86042-4000
Phone (928) 737-6000

Other names 1

  • HOPI HEALTH CARE CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120130000104 AZ Part A Provider - Indian Health Services Facility 5698941466 Practice locations: Polacca, AZ
O20120222000148 TX Part B Supplier - Clinic/Group Practice 9436325420 Receives reassigned benefits from 202 practitioners
Practice locations: Polacca, AZ

National Provider Directory

National Provider Directory
Tax ID family
Dhew Indian Health Service Health Services Mental Health Adm18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 224

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 224

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464048000000",
    "number": "1356628028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HIGHWAY 264 MILEPOST 388",
            "address_2": "PO BOX 4000",
            "city": "POLACCA",
            "state": "AZ",
            "postal_code": "860424000",
            "telephone_number": "928-737-6000",
            "fax_number": "928-737-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 264 MILEPOST 388",
            "city": "POLACCA",
            "state": "AZ",
            "postal_code": "860424000",
            "telephone_number": "928-737-6000",
            "fax_number": "928-737-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS IHS PHOENIX AREA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2016-05-24",
        "status": "A",
        "authorized_official_last_name": "MELVIN",
        "authorized_official_first_name": "DARYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-737-6010"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "AZ",
            "license": "366937",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOPI HEALTH CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Polacca, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.