NPIMap

Organization Active NPI

Dignity Health

  • Emergency Care Clinic/Center
  • Glendale, AZ
National Provider Identifier
1609408665
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
DIGNITY HEALTH
Practice address
17040 N 51St Ave Ste 100
Glendale, AZ 85308-1496
Phone
(602) 406-1700
Fax
(602) 406-1180
NPI assigned
Feb 7, 2020
Organization subpart
Yes
Parent organization
DIGNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Authorized official

Name
Jeffrey Jackson
Title
Chief Financial Officer
Phone
(602) 406-4618

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

17040 N 51St Ave Ste 100
Glendale, AZ 85308-1496

Mailing address

17040 N 51St Ave Ste 100
Glendale, AZ 85308-1496

Other names 1

  • St. Josephs Hospital and Medical Center Emergency Dept-Glendale Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070801000387 AZ Part A Provider - Hospital 2062320559 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Glendale, AZ; Litchfield Park, AZ

Hospital certification: CCN 030024

Legal name
DIGNITY HEALTH
Doing business as
ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 16, 2016
Beds
586
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Oct 11, 1954 in CA
Enrollment address
350 W Thomas Rd
Phoenix, AZ 85013-4409
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Other

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
St Josephs Hospital and Medical CenterCCN 030024
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
03D2179957Dignity Health St Joseph'S Hospital &17040 N 51St Ave, Suite 100, Glendale, AZ 85308AccreditationAug 3, 2027

National Provider Directory

National Provider Directory
Tax ID family
Catholic Healthcare West74 organizations share this tax ID, including this one
Part of
Catholic Healthcare West

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

17040 N 51st Ave
Ste 100
Glendale, AZ 85308
Phone (602) 406-1164

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Marvin O'Quinn Individual Corporate OfficerPresident/Chair Feb 1, 2019
Corporate DirectorPresident/Chair Jan 27, 2021
Commonspirit Health Organization, Chicago, IL Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2019 100%
Operational/Managerial Control Feb 1, 2019
Scott Carswell Individual Corporate DirectorBoard Member Jan 27, 2021
Dignity Health Organization, San Francisco, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 12, 1986 100%
Daniel Morissette Individual Corporate OfficerSevp/Chief Financial Officer Feb 1, 2019
Mitch Melfi Individual Corporate OfficerVice Chair & Secretary Jan 27, 2021
Corporate DirectorBoard Member Jan 27, 2021
Elizabeth Shih Individual Corporate OfficerAsst Secretary Jan 27, 2021
Corporate DirectorBoard Member Jan 27, 2021
Steven W Scharmann Individual Corporate OfficerAdministrator of Payor Programs Nov 14, 2022
Operational/Managerial ControlVP, Finance and Rev Cycle Feb 1, 2019
John E Petersdorf Individual Corporate OfficerAdministrator of Payor Programs Nov 14, 2022
Operational/Managerial ControlSVP/Operations Finance Feb 1, 2019

Practitioners & affiliated clinicians

Affiliated clinicians 938

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 938

NPI Registry JSON

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1609408665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17040 N 51ST AVE STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17040 N 51ST AVE STE 100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081496",
            "telephone_number": "602-406-1700",
            "fax_number": "602-406-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIGNITY HEALTH",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "602-406-4618"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Josephs Hospital and Medical Center Emergency Dept-Glendale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.