NPIMap

Organization Active NPI

North Country Healthcare Inc.

  • Urgent Care Clinic/Center
  • Grand Canyon, AZ
National Provider Identifier
1366774044
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
NORTH COUNTRY HEALTHCARE INC.
Practice address
1 Clinic Road
Grand Canyon, AZ 86023
Phone
(928) 638-2551
Fax
(928) 638-2287
NPI assigned
Feb 5, 2010
Organization subpart
Yes
Parent organization
NORTH COUNTRY HEALTHCARE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Authorized official

Name
Ann M Roggenbuck
Title
Ceo
Phone
(928) 774-8325

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X AZ Primary

Addresses

Primary practice location

1 Clinic Road
Grand Canyon, AZ 86023

Mailing address

PO Box 3630
Flagstaff, AZ 86003-3630
Phone (928) 213-6121

Other identifiers 1

IdentifierTypeStateIssuer
OTC3823OtherAZARIZONA DEPARTMENT OF HEALTH SERVICES

Other names 1

  • Grand Canyon Urgent Care Other name

National Provider Directory

National Provider Directory
Tax ID family
North Country Community7 organizations share this tax ID, including this one
Part of
North Country Community

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265328000000",
    "number": "1366774044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630",
            "telephone_number": "928-213-6121",
            "fax_number": "928-774-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CLINIC ROAD",
            "city": "GRAND CANYON",
            "state": "AZ",
            "postal_code": "86023",
            "telephone_number": "928-638-2551",
            "fax_number": "928-638-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY HEALTHCARE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH COUNTRY HEALTHCARE INC.",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-02-05",
        "status": "A",
        "authorized_official_last_name": "ROGGENBUCK",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-774-8325"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA DEPARTMENT OF HEALTH SERVICES",
            "identifier": "OTC3823",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Canyon Urgent Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grand Canyon, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; 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.