NPIMap

Organization Active NPI

Fort Defiance Indian Hospital

  • Chronic Disease Hospital
  • Fort Defiance, AZ
National Provider Identifier
1619251709
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Chronic Disease HospitalTaxonomy code 281P00000X
License
RN139390 Issued in AZ
Legal business name
FORT DEFIANCE INDIAN HOSPITAL
Practice address
Corner of Route 7 and Route 12
Corner of Route 7 and Route 12
Fort Defiance, AZ 86504
Phone
(928) 729-8000
NPI assigned
Oct 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Authorized official

Name
Wellementta Baker
Title
Registered Nurse
Phone
(928) 729-8464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chronic Disease Hospital 281P00000X RN139390 AZ Primary

Addresses

Primary practice location

Corner of Route 7 and Route 12
Corner of Route 7 and Route 12
Fort Defiance, AZ 86504

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649
Phone (928) 729-8000

National Provider Directory

National Provider Directory
Tax ID family
Fort Defiance Indian Hospital Board Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1619251709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE 7 AND ROUTE 12",
            "address_2": "CORNER OF ROUTE 7 AND ROUTE 12",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "86504",
            "telephone_number": "928-729-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT DEFIANCE INDIAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-06",
        "last_updated": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "WELLEMENTTA",
        "authorized_official_title_or_position": "REGISTERED NURSE",
        "authorized_official_telephone_number": "928-729-8464"
    },
    "taxonomies": [
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": "AZ",
            "license": "RN139390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.