NPIMap

Organization Active NPI

Community Intervention Associates, Inc

Doing business as Community Health Associates

  • Community/Behavioral Health Agency
  • Green Valley, AZ
National Provider Identifier
1356791701
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY INTERVENTION ASSOCIATES, INC
Doing business as
Community Health Associates
Practice address
275 W Continental Rd
Suites 133a, B, C, D and 141
Green Valley, AZ 85622-3624
Phone
(928) 376-0026
Fax
(928) 782-2298
NPI assigned
Jun 16, 2016
Last updated
Jun 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Authorized official

Name
Fred Cogburn
Title
Ceo
Phone
(928) 376-0026

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

275 W Continental Rd
Suites 133a, B, C, D and 141
Green Valley, AZ 85622-3624

Mailing address

2851 S Avenue B
BLDG 4
Yuma, AZ 85364-7726
Phone (928) 376-0026

Other names 1

  • Community Health Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120201000213 AZ Part B Supplier - Clinic/Group Practice 4880851971 Receives reassigned benefits from 34 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Yuma, AZ; Tucson, AZ; San Luis, AZ; Parker, AZ; Nogales, AZ; Green Valley, AZ; Douglas, AZ; Casa Grande, AZ…

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Community Intervention Assciates Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

275 W Continental Rd
Ste 133D
Green Valley, AZ 85622

410 S Maiden Ln
Yuma, AZ 85364
Phone (520) 604-8306

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1356791701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 S AVENUE B",
            "address_2": "BLDG 4",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647726",
            "telephone_number": "928-376-0026",
            "fax_number": "928-782-2298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W CONTINENTAL RD",
            "address_2": "SUITES 133A, B, C, D AND 141",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856223624",
            "telephone_number": "928-376-0026",
            "fax_number": "928-782-2298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY INTERVENTION ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "COGBURN",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-376-0026"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.