NPIMap

Organization Active NPI

American Indian Prevention Coaltion

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1407071095
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH-3105 Issued in AZ
Legal business name
AMERICAN INDIAN PREVENTION COALTION
Practice address
4520 N Central Ave Ste 130
Phoenix, AZ 85012-1804
Phone
(602) 424-1600
Fax
(602) 532-7202
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Authorized official

Name
Bonny Beach
Title
Ceo
Phone
(602) 424-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH-3105 AZ Primary

Addresses

Primary practice location

4520 N Central Ave Ste 130
Phoenix, AZ 85012-1804

Mailing address

PO Box 25047
Phoenix, AZ 85002-5047
Phone (602) 424-1600

Other identifiers 1

IdentifierTypeStateIssuer
790255MedicaidAZ

Other names 1

  • NDNS4Wellness Doing business as

National Provider Directory

National Provider Directory
Tax ID family
American Indian Prevention Coalition6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

4520 N Central Ave
Ste 130
Phoenix, AZ 85012
Phone (602) 424-1600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1407071095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25047",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850025047",
            "telephone_number": "602-424-1600",
            "fax_number": "602-532-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 N CENTRAL AVE STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121804",
            "telephone_number": "602-424-1600",
            "fax_number": "602-532-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN INDIAN PREVENTION COALTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "BEACH",
        "authorized_official_first_name": "BONNY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-424-1600"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-3105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790255",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NDNS4Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.