NPIMap

Organization Active NPI

White Mountain Apache

  • Non-emergency Medical Transport (VAN)
  • Whiteriver, AZ
National Provider Identifier
1619148772
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
WHITE MOUNTAIN APACHE
Practice address
522 South Fourth Avenue
Whiteriver, AZ 85941
Phone
(928) 338-1808
Fax
(928) 338-5254
NPI assigned
Mar 17, 2008
Organization subpart
Yes
Parent organization
WHITE MOUNTAIN APACHE TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Emmie Cromwell
Title
Director
Phone
(928) 338-1808

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

522 South Fourth Avenue
Whiteriver, AZ 85941

Mailing address

PO Box 1210
Whiteriver, AZ 85941-1210
Phone (928) 338-1808

Other identifiers 1

IdentifierTypeStateIssuer
044701MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Rainbow Treatment Center White Mountain Apache Tribe5 organizations share this tax ID, including this one
Part of
Rainbow Treatment Center White Mountain Apache Tribe

Other organizations with this tax ID 4

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1619148772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "859411210",
            "telephone_number": "928-338-1808",
            "fax_number": "928-338-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 SOUTH FOURTH AVENUE",
            "city": "WHITERIVER",
            "state": "AZ",
            "postal_code": "85941",
            "telephone_number": "928-338-1808",
            "fax_number": "928-338-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MOUNTAIN APACHE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHITE MOUNTAIN APACHE TRIBE",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "CROMWELL",
        "authorized_official_first_name": "EMMIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "928-338-1808"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044701",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteriver, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.