Organization Active NPI

Compass Medical Center Heber, PLLC

  • General Practice Physician
  • Overgaard, AZ
National Provider Identifier
1417570664
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
COMPASS MEDICAL CENTER HEBER, PLLC
Practice address
2931 Highway 260
Overgaard, AZ 85933
Phone
(928) 536-5525
Fax
(928) 536-3735
NPI assigned
May 22, 2020
Last updated
Jun 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Authorized official

Name
Justin James Woodside, DCNPI 1306005327
Title
Owner
Phone
(928) 536-5525

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

2931 Highway 260
Overgaard, AZ 85933

Mailing address

PO Box 2340
Overgaard, AZ 85933
Phone (928) 536-5525

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1417570664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2340",
            "city": "OVERGAARD",
            "state": "AZ",
            "postal_code": "85933",
            "telephone_number": "928-536-5525",
            "fax_number": "928-536-3735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2931 HIGHWAY 260",
            "city": "OVERGAARD",
            "state": "AZ",
            "postal_code": "85933",
            "telephone_number": "928-536-5525",
            "fax_number": "928-536-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASS MEDICAL CENTER HEBER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "WOODSIDE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-536-5525",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overgaard, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.