NPIMap

Organization Active NPI

American Indian Association of Tucson, Inc.

Doing business as Tucson Indian Center

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
National Provider Identifier
1457935934
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
AMERICAN INDIAN ASSOCIATION OF TUCSON, INC.
Doing business as
Tucson Indian Center
Practice address
160 N Stone Ave
Tucson, AZ 85701-1502
Phone
(520) 884-7133
Fax
(520) 884-0240
NPI assigned
May 10, 2021
Last updated
May 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Phoebe Ann Cager, MSW
Title
Health Services Director
Phone
(520) 884-7131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

160 N Stone Ave
Tucson, AZ 85701-1502

Mailing address

PO Box 2307
Tucson, AZ 85702-2307
Phone (520) 884-7133

Other names 1

  • Tucson Indian Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20241206002753 AZ Part A Provider - Federally Qualified Health Center (FQHC) 8022544519 Practice locations: Tucson, AZ
O20250319001991 TX Part B Supplier - Clinic/Group Practice 8022544519 Receives reassigned benefits from 4 practitioners
Practice locations: Tucson, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457935934. Details of each certification follow.

Federally qualified health center certification: CCN 031047

Legal name
AMERICAN INDIAN ASSOCIATION OF TUCSON, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 5, 2024
Last certification
Dec 5, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
160 N Stone Ave
Tucson, AZ 85701-1502

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
03D2129615Tucson Indian Center160 N Stone Ave, Tucson, AZ 85701Certificate of waiverApr 23, 2027

National Provider Directory

National Provider Directory

Locations

160 N Stone Ave
Tucson, AZ 85701
Phone (520) 884-7131

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Michael a. Spotted Wolf Individual W-2 Managing EmployeeFinance Director Apr 11, 2005
Jacob Jeffrey Bernal Individual W-2 Managing EmployeeExecutive Director Nov 26, 1990

Practitioners & affiliated clinicians

Practitioners 8

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": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1457935934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2307",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857022307",
            "telephone_number": "520-884-7133",
            "fax_number": "520-884-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N STONE AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857011502",
            "telephone_number": "520-884-7133",
            "fax_number": "520-884-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN INDIAN ASSOCIATION OF TUCSON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "CAGER",
        "authorized_official_first_name": "PHOEBE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "HEALTH SERVICES DIRECTOR",
        "authorized_official_telephone_number": "520-884-7131",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tucson Indian Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tucson Indian Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.