NPIMap

Organization Active NPI

West Yavapai Guidance Clinic, Inc.

Doing business as Polara Health

  • Adult Medicine Physician
  • Prescott, AZ
National Provider Identifier
1629618061
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
WEST YAVAPAI GUIDANCE CLINIC, INC.
Doing business as
Polara Health
Practice address
625 W Hillside Ave
Prescott, AZ 86301-1936
Phone
(928) 445-5211
NPI assigned
Jan 14, 2020
Last updated
Jun 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Linda Diane McLain
Title
Credentialing Specialist
Phone
(928) 445-5211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X NU Primary

Addresses

Primary practice location

625 W Hillside Ave
Prescott, AZ 86301-1936

Mailing address

3343 N Windsong Dr
Prescott Valley, AZ 86314-1213
Phone (928) 445-5211

Other names 1

  • Polara Health Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address him@wygc.org Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
W Yavapai Guidance CL Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1629618061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 N WINDSONG DR",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141213",
            "telephone_number": "928-445-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W HILLSIDE AVE",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011936",
            "telephone_number": "928-445-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST YAVAPAI GUIDANCE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "MCLAIN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "928-445-5211"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@wygc.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "625 W Hillside Ave",
            "city": "Prescott",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863011936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Polara Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.