NPIMap

Organization Active NPI

Northland Hospice & Palliative Care Inc

  • Lodging Provider
  • Flagstaff, AZ
National Provider Identifier
1366947152
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lodging ProviderTaxonomy code 177F00000X
License
AL10516H Issued in AZ
Legal business name
NORTHLAND HOSPICE & PALLIATIVE CARE INC
Practice address
452 N Switzer Canyon Dr
Flagstaff, AZ 86001-4855
Phone
(928) 779-1227
NPI assigned
Mar 26, 2018
Organization subpart
Yes
Parent organization
NORTHLAND HOSPICE & PALLIATIVE CARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Authorized official

Name
Katherine A Simmons
Title
Ceo
Phone
(928) 774-1227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lodging Provider 177F00000X AL10516H AZ Primary

Addresses

Primary practice location

452 N Switzer Canyon Dr
Flagstaff, AZ 86001-4855

Mailing address

220 W Forest Ave
Flagstaff, AZ 86001-1477
Phone (928) 779-1227

Other identifiers 2

IdentifierTypeStateIssuer
110495MedicaidAZ
726185MedicaidAZ

Other names 1

  • Elaine's Forest House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northland Hospice Palliative Care3 organizations share this tax ID, including this one
Part of
Northland Hospice Palliative Care

Other organizations with this tax ID 2

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

Locations

220 W Forest Ave
Flagstaff, AZ 86001

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1366947152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W FOREST AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011477",
            "telephone_number": "928-779-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 N SWITZER CANYON DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014855",
            "telephone_number": "928-779-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND HOSPICE & PALLIATIVE CARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHLAND HOSPICE & PALLIATIVE CARE INC",
        "enumeration_date": "2018-03-26",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-774-1227"
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": "AZ",
            "license": "AL10516H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110495",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "726185",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elaine's Forest House",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elaine's Forest House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2018; 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.