NPIMap

Organization Active NPI

Chiricahua Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Sierra Vista, AZ
National Provider Identifier
1629499397
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHIRICAHUA COMMUNITY HEALTH CENTERS, INC.
Practice address
115 Calle Portal
Sierra Vista, AZ 85635-2232
Phone
(520) 459-3011
Fax
(520) 364-4261
NPI assigned
Dec 26, 2013
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Jonathan P Melk, MD
Title
Ceo
Phone
(520) 364-6852

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory
Tax ID family
Chiricahua Community Health22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

115 Calle Portal
Sierra Vista, AZ 85635

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

NPPES NPI Registry

Primary practice location

115 Calle Portal
Sierra Vista, AZ 85635-2232

Mailing address

1205 N F Ave
Douglas, AZ 85607-1920
Phone (520) 364-6852

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
945170MedicaidAZ

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 1, 2021.

{
    "created_epoch": "1388016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1629499397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N F AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856071920",
            "telephone_number": "520-364-6852",
            "fax_number": "520-364-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CALLE PORTAL",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352232",
            "telephone_number": "520-459-3011",
            "fax_number": "520-364-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRICAHUA COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-26",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "MELK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "520-364-6852",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "945170",
            "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 Sep 1, 2021; 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.