NPIMap

Organization Active NPI

Community Partners Integrated Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Sierra Vista, AZ
National Provider Identifier
1376065342
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
COMMUNITY PARTNERS INTEGRATED HEALTHCARE, INC.
Practice address
2273 E Wilcox Dr
Sierra Vista, AZ 85635-2755
Phone
(520) 226-9002
Fax
(520) 459-0563
NPI assigned
Jul 12, 2017
Last updated
Apr 20, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY PARTNERS INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Rose Mary Lopez, MBA
Title
President and Ceo
Phone
(520) 721-1887

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X OTC8548 AZ
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

2273 E Wilcox Dr
Sierra Vista, AZ 85635-2755

Mailing address

PO Box 86537
Tucson, AZ 85754-6537
Phone (520) 721-1887

Other identifiers 2

IdentifierTypeStateIssuer
325286MedicaidAZ
OTC8548OtherAZBUREAU OF MEDICAL FACLITIES LICENSING

Other names 2

  • Assurance Health and Wellness Former legal business name
  • SVIC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140716002626 AZ Part B Supplier - Clinic/Group Practice 7315163938 Receives reassigned benefits from 48 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Benson, AZ; Phoenix, AZ; Safford, AZ; Sierra Vista, AZ; Tucson, AZ; Yuma, AZ

Other NPIs on the same Medicare enrollment 10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2132573Community Partners Integrated Healthcare, Inc2273 E Wilcox Dr, Sierra Vista, AZ 85635Certificate of waiverJun 21, 2027

National Provider Directory

National Provider Directory
Part of
Community Partners Inc

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.

Practitioners & affiliated clinicians

Practitioners 12

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": "1499817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1376065342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86537",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857546537",
            "telephone_number": "520-721-1887",
            "fax_number": "520-721-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2273 E WILCOX DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352755",
            "telephone_number": "520-226-9002",
            "fax_number": "520-459-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PARTNERS INTEGRATED HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY PARTNERS INC.",
        "enumeration_date": "2017-07-12",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "520-721-1887",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "OTC8548",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325286",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF MEDICAL FACLITIES LICENSING",
            "identifier": "OTC8548",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Assurance Health and Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "SVIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.