NPIMap

Organization Active NPI

Maricopa County Special Health Care District

Doing business as Maricopa Integrated Health

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
National Provider Identifier
1629497474
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Doing business as
Maricopa Integrated Health
Valleywise Health
Practice address
1101 N Central Ave Ste 204
Phoenix, AZ 85004-1844
Phone
(602) 344-8180
Fax
(602) 344-8122
NPI assigned
Apr 9, 2014
Last updated
Jul 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Pam Fowler
Title
System Director of Reimbursement
Phone
(602) 344-2830

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
General Acute Care Hospital 282N00000X H3673 AZ

Addresses

Primary practice location

1101 N Central Ave Ste 204
Phoenix, AZ 85004-1844

Mailing address

PO Box 29670
Phoenix, AZ 85038-9670
Phone (602) 344-8180

Other identifiers 1

IdentifierTypeStateIssuer
946491MedicaidAZ

Other names 2

  • Maricopa Integrated Health Doing business as
  • Valleywise Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071002000192 AZ Part A Provider - Hospital 4688583651 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Peoria, AZ; Mesa, AZ
O20251014002510 AZ Part A Provider - Federally Qualified Health Center (FQHC) 4688583651 Practice locations: Phoenix, AZ

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1629497474. Details of each certification follow.

Hospital certification: CCN 030022

Legal name
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Doing business as
VALLEYWISE HEALTH
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 20, 2018
Beds
758
Ownership / control type
Local
Organization structure
GovernmentNon-profit
Enrollment address
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Federally qualified health center certification: CCN 031065

Legal name
MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
Doing business as
VALLEYWISE COMMUNITY HEALTH CENTER - MCDOWELL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 17, 2025
Last certification
Nov 17, 2025
Ownership / control type
For profit – corporation
Organization structure
GovernmentNon-profit
Enrollment address
1101 N Central Ave
Ste 204
Phoenix, AZ 85004-1844

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

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 11

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Valleywise Health Medical CenterCCN 030022 · All quality measures
Overall star rating
1 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Locations

1101 N Central Ave
Fl 2
Phoenix, AZ 85004

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
Martin Demos Individual Corporate DirectorDirector Dec 2, 2024
Virginia Korte Individual Corporate DirectorDirector Dec 2, 2024
Barbara Mundell Individual Corporate DirectorDirector Feb 11, 2025
Maricopa County Special Health Care District Organization, Phoenix, AZ Medical provider/supplier, Non-profit Operational/Managerial Control Jan 1, 2005 100%
Earl Wilcox Individual Corporate DirectorDirector Dec 2, 2024
Claire Frieda Agnew Individual Corporate OfficerInterim Cfo Aug 1, 2020
Corporate OfficerExecutive VP & Cfo Aug 1, 2020
W-2 Managing EmployeeExecutive VP & Cfo Aug 1, 2020
James W. Thomas Individual Corporate Director Dec 4, 2018
Pamela Fowler Individual W-2 Managing Employee Jul 23, 2018
Operational/Managerial ControlDirector Jul 23, 2018
Corporate DirectorSystem Director of Reimbursement Jul 23, 2018
W-2 Managing EmployeeSystem Director of Reimbursement Jul 23, 2018
Stephen Purves Individual Corporate Officer Sep 30, 2013
W-2 Managing EmployeePresident and Chief Executive Offic Sep 30, 2013
Corporate OfficerPresident & Ceo Apr 24, 2014
W-2 Managing EmployeePresident & Ceo Apr 24, 2014

Owners & managing parties with NPI records 13

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 13

All facility ownership & control disclosures 12

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Valleywise HealthPhoenix, AZ, CCN 03S022 Hospital Operational/Managerial Control Jan 1, 2005
Valleywise HealthPhoenix, AZ, CCN 030022 Hospital Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Comprehensive Health Center - PeoriaPeoria, AZ, CCN 031073 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Health Community Health Center - GuadalupeGuadalupe, AZ, CCN 031066 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - North PhoenixPhoenix, AZ, CCN 031067 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - West MaryvalePhoenix, AZ, CCN 031075 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Comprehensive Health Center - PhoenixPhoenix, AZ, CCN 031072 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - South Phoenix LaveenPhoenix, AZ, CCN 031071 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - ChandlerChandler, AZ, CCN 031082 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - AvondaleAvondale, AZ, CCN 031080 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - MesaMesa, AZ, CCN 031074 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005
Valleywise Community Health Center - South CentralPhoenix, AZ, CCN 031083 Federally qualified health center Operational/Managerial Control (100%) Jan 1, 2005

Owned or controlled facilities with NPI records 17

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 17

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

Affiliated clinicians 409

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

View all 409

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1629497474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29670",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389670",
            "telephone_number": "602-344-8180",
            "fax_number": "602-344-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N CENTRAL AVE STE 204",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041844",
            "telephone_number": "602-344-8180",
            "fax_number": "602-344-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2024-07-15",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "602-344-2830"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "AZ",
            "license": "H3673",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "946491",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maricopa Integrated Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maricopa Integrated Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Valleywise Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.