NPIMap

Organization Active NPI

Flagstaff Medical Center

Doing business as FMC Behavioral Health Services

  • Psychiatric Hospital Unit
  • Flagstaff, AZ
National Provider Identifier
1649370875
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Legal business name
FLAGSTAFF MEDICAL CENTER
Doing business as
FMC Behavioral Health Services
Practice address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone
(928) 779-3366
NPI assigned
Sep 25, 2006
Last updated
Apr 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Robert Cofield
Title
Chief Operating Officer
Phone
(928) 773-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X NU Primary

Addresses

Primary practice location

1200 N Beaver St
Flagstaff, AZ 86001-3118

Mailing address

1200 N Beaver St
Attn: Managed Care Contracting
Flagstaff, AZ 86001-3118
Phone (928) 213-6543

Other names 1

  • FMC Behavioral Health Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031230000199 AZ Part B Supplier - Clinic/Group Practice 2769392554 Receives reassigned benefits from 36 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Flagstaff, AZ
O20050506000762 AZ Part A Provider - Hospital 2769392554 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Flagstaff, AZ
O20071018000772 AZ Part A Provider - Hospital 2769392554 Practice locations: Flagstaff, AZ

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1649370875. Details of each certification follow.

Hospital certification: CCN 030023

Legal name
FLAGSTAFF MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 20, 2017
Beds
264
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 6, 1936 in AZ
Enrollment address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Hospital subgroups
General, Psychiatric

Hospital certification: CCN 03S023

Legal name
FLAGSTAFF MEDICAL CENTER
Organization structure
CorporationNon-profit
Incorporated
Jan 6, 1936 in AZ
Enrollment address
1200 N Beaver St
Flagstaff, AZ 86001-3118
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Flagstaff Medical CenterCCN 030023 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Tonia Douros Individual W-2 Managing EmployeeProvider Relations Specialist Apr 18, 2019
W-2 Managing EmployeeProvider Relations Specialist Apr 17, 2019
Coral J Evans-Randall Individual Corporate DirectorBoard Member Aug 1, 2025
Randall Garrison Individual Corporate DirectorBoard Member Apr 18, 2019
Corporate DirectorBoard Member Apr 17, 2019
Kathy Martinez Individual W-2 Managing EmployeeManager Manage Care Contracting Apr 1, 2016
Janina C Johnson Individual Corporate DirectorBoard Member Aug 1, 2025
Northern Arizona Healthcare Corporation Organization, Flagstaff, AZ Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Mar 13, 1996 100%
Operational/Managerial Control Mar 13, 1995
5% Or Greater Direct Ownership Interest Mar 13, 1995
Robert Cofield Individual Corporate OfficerChief Operating Officer Nov 27, 2023
John Rivers Individual Corporate DirectorBoard Member Apr 18, 2019
Corporate DirectorBoard Member Apr 17, 2019
Richard L Evnen Individual Corporate DirectorBoard Member Jun 1, 2023
Troy Lorents Individual Corporate DirectorBoard Member Nov 1, 2021
Stephanie M Timonen Individual W-2 Managing EmployeeAudit Program Manager Jan 1, 2016
David R Cheney Individual Corporate OfficerPresident and Ceo Jun 12, 2023
Paula Herald Individual Corporate DirectorBoard Member Jun 1, 2023
William J Badger Individual Corporate DirectorBoard Member Apr 6, 2023
Daryl Melvin Individual Corporate DirectorBoard Member Sep 1, 2022
Brian Craft Individual Corporate OfficerChief Financial Officer Oct 6, 2025

Owners & managing parties with NPI records 2

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 20

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 20

Affiliated clinicians 566

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

View all 566

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1649370875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "address_2": "ATTN: MANAGED CARE CONTRACTING",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-213-6543",
            "fax_number": "928-214-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013118",
            "telephone_number": "928-779-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSTAFF MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "COFIELD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "928-773-2010"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMC Behavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.