Individual provider Active NPI

Rodney Scott Poche, LMFT

  • Marriage & Family Therapist
  • St. Johns, AZ
National Provider Identifier
1649334897
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT10133 Issued in AZ
Practice address
470 W Cleveland
St. Johns, AZ 85936-0579
Phone
(928) 337-4301
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT10133 AZ Primary

Addresses

Primary practice location

470 W Cleveland
St. Johns, AZ 85936-0579

Mailing address

PO Box 579
Saint Johns, AZ 85936-0579
Phone (928) 337-4301

Other identifiers 1

IdentifierTypeStateIssuer
821258MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240105003687 AZ Practitioner - Marriage and Family Therapist 3678717154 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT10133AZMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Colorado Behavioral Health Center Inc. CurrentSince Aug 1, 2002 Accepting new patients
Little Colorado Behavioral Health Center Inc. CurrentSince Jan 1, 2024 Accepting new patients
North Country Healthcare, Inc. PastSince Feb 1, 2016 Accepting new patients

Locations

1855 W Baseline Rd
Ste 101
Mesa, AZ 85202

Interoperability endpoints

  • Direct secure messaging: scott.pochelmft.p1@direct.cbridges.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
North Country Healthcare IncKingman, AZ, CCN 031951 Federally qualified health center Corporate Director Feb 1, 2016

Owned or controlled facilities with NPI records 1

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649334897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "SAINT JOHNS",
            "state": "AZ",
            "postal_code": "859360579",
            "telephone_number": "928-337-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 W CLEVELAND",
            "city": "ST. JOHNS",
            "state": "AZ",
            "postal_code": "859360579",
            "telephone_number": "928-337-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCHE",
        "first_name": "RODNEY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LMFT10133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "821258",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Johns, AZ

Sources for this page

Verify at the official NPI Registry.