White Mountain Regional Medical Center Rural Health Clinic - St. Johns

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

OTC7868 Issued in AZ

Legal business name

WHITE MOUNTAIN REGIONAL MEDICAL CENTER RURAL HEALTH CLINIC - ST. JOHNS

Practice address

110 East First Street South
St. Johns, AZ 85936

Phone

(928) 333-7333

Fax

(928) 333-7157

NPI assigned

Jul 10, 2017

Organization subpart

Yes

Parent organization

WHITE MOUNTAIN COMMUNITIES HOSPITAL INCAs reported in NPPES

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

Authorized official

Name

Tracy Nelson, RN-BC

Title

Clinic Manager

Phone

(928) 333-7173

Specialties & licenses 1

Addresses

Tax ID family

White Mountain Regional Medical Center3 organizations share this tax ID, including this one

Part of

White Mountain Regional Medical Center

Other organizations with this tax ID 2

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

• White Mountain Regional Medical Center

  • Pharmacy
  • Springerville, AZ
  • NPI 1184594517
  NPD tax ID
• White Mountain Regional Medical Center Rural Health Clinic

  • Clinic/Center
  • Eagar, AZ
  • NPI 1598292377
  NPD tax ID

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1497277651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S MOUNTAIN AVE",
            "city": "SPRINGERVILLE",
            "state": "AZ",
            "postal_code": "859385104",
            "telephone_number": "928-333-7333",
            "fax_number": "928-333-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EAST FIRST STREET SOUTH",
            "city": "ST. JOHNS",
            "state": "AZ",
            "postal_code": "85936",
            "telephone_number": "928-333-7333",
            "fax_number": "928-333-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MOUNTAIN REGIONAL MEDICAL CENTER RURAL HEALTH CLINIC - ST. JOHNS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITE MOUNTAIN COMMUNITIES HOSPITAL INC",
        "enumeration_date": "2017-07-10",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "928-333-7173",
        "authorized_official_credential": "RN-BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "OTC7868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summit Healthcare Medical Associates
• Superior Speech and Language Services, LLC
• Joseph Donovan Tenney, D.D.S.
• Sandra Maureen Thompson, LPC
• Western Drug Inc
• Tifani Kaye Wilhelm
• Carl S Wiltbank, DPT

• Clinic/Center in St. Johns, AZ
• Providers in St. Johns, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.