NPIMap

Organization Active NPI

Phoenix Indian Center, Inc.

  • Community/Behavioral Health Agency
  • Phoenix, AZ
National Provider Identifier
1487793360
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH138 Issued in AZ
Legal business name
PHOENIX INDIAN CENTER, INC.
Practice address
4520 N Central Ave
Suite 250
Phoenix, AZ 85012-1828
Phone
(602) 264-6768
Fax
(602) 274-7486
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Patricia Hibbeler, MA
Title
Chief Executive Officer
Phone
(602) 264-6768

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH138 AZ Primary

Addresses

Primary practice location

4520 N Central Ave
Suite 250
Phoenix, AZ 85012-1828

Mailing address

4520 N Central Ave
Suite 250
Phoenix, AZ 85012-1828
Phone (602) 264-6768

Other identifiers 1

IdentifierTypeStateIssuer
740367MedicaidAZ

National Provider Directory

National Provider Directory

Locations

4520 N Central Ave
Ste 250
Phoenix, AZ 85012
Phone (602) 264-6768

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487793360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 N CENTRAL AVE",
            "address_2": "SUITE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121828",
            "telephone_number": "602-264-6768",
            "fax_number": "602-274-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 N CENTRAL AVE",
            "address_2": "SUITE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121828",
            "telephone_number": "602-264-6768",
            "fax_number": "602-274-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX INDIAN CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HIBBELER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "602-264-6768",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "740367",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 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.