NPIMap

Organization Active NPI

Family Health Center of Sierra Vista, PC

  • Family Medicine Physician
  • Sierra Vista, AZ
National Provider Identifier
1558563114
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16890 Issued in AZ
Legal business name
FAMILY HEALTH CENTER OF SIERRA VISTA, PC
Practice address
1800 E Wilcox Dr
Sierra Vista, AZ 85635-2756
Phone
(520) 459-3116
Fax
(520) 459-7397
NPI assigned
Jun 4, 2007
Last updated
Dec 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Authorized official

Name
Ralph E Mayberry, MDNPI 1063487486
Title
President
Phone
(520) 459-3116

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
Family Medicine Physician 207Q00000X 16890 AZ Primary

Addresses

Primary practice location

1800 E Wilcox Dr
Sierra Vista, AZ 85635-2756

Mailing address

1800 E Wilcox Dr
Sierra Vista, AZ 85635-2756
Phone (520) 459-3116

Other identifiers 3

IdentifierTypeStateIssuer
HEALTHNETOtherAZ1Z4100
A002OtherAZTRICARE WPS
CH7902OtherAZRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1558563114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E WILCOX DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352756",
            "telephone_number": "520-459-3116",
            "fax_number": "520-459-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E WILCOX DR",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352756",
            "telephone_number": "520-459-3116",
            "fax_number": "520-459-7397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER OF SIERRA VISTA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "MAYBERRY",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-459-3116",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "16890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1Z4100",
            "identifier": "HEALTHNET",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE WPS",
            "identifier": "A002",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7902",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.