Individual provider Active NPI

John S Condojani, D.O.

  • Family Medicine Physician
  • Whiteriver, AZ
National Provider Identifier
1497761555
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0-317 Issued in ID
Practice address
200 W. Hospital Dr
Whiteriver, AZ 85941
Phone
(928) 338-4911
NPI assigned
Jul 31, 2006
Last updated
Jan 22, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0-317 ID Primary

Addresses

Primary practice location

200 W. Hospital Dr
Whiteriver, AZ 85941

Mailing address

PO Box 860
Whiteriver, AZ 85941-0860
Phone (928) 338-4911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050920001121 TX Practitioner - Family Practice 2668463860 Reassigns benefits to 1 organization
I20150716001976 AZ Practitioner - Family Practice 2668463860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winslow Memorial Hospital IncGroup PAC ID 8628988409, 44 clinicians

Practice addresses (Care Compare)

1501 N Williamson Ave
Winslow, AZ 86047-2735
Phone (928) 289-4691

500 Indiana Ave
Winslow, AZ 86047-2169

500 N Indiana Ave
Winslow, AZ 86047-2169
Phone (928) 289-4646

SWC Navajo Route 15 and 60
1 Medical Center Dr
Dilkon, AZ 86047-2169
Phone (928) 289-4646

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4563AZMDGeneral Practice Dentistry
0-317IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winslow Indian Health Care Center, Inc Current Accepting new patients
Winslow Indian Health Care Group CurrentSince Aug 11, 2014 Accepting new patients
Dilkon Medical Center Current Accepting new patients
Winslow Memorial Hospital Inc CurrentSince May 19, 2015 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Aug 11, 2014 Accepting new patients

Locations

1500 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-3396

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

500 Indiana Ave
Winslow, AZ 86047

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1497761555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "859410860",
            "telephone_number": "928-338-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W. HOSPITAL DR",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "85941",
            "telephone_number": "928-338-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDOJANI",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "0-317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteriver, AZ

Sources for this page

Verify at the official NPI Registry.