NPIMap

Organization Active NPI

Mt Graham Regional Medical Center Inc

  • Home Health Agency
  • Safford, AZ
National Provider Identifier
1659337848
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA-210 Issued in AZ
Legal business name
MT GRAHAM REGIONAL MEDICAL CENTER INC
Practice address
1600 S. 20TH Ave., BLDG. E
Safford, AZ 85546
Phone
(928) 428-5668
Fax
(928) 348-3868
NPI assigned
Apr 25, 2006
Last updated
Apr 26, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MT GRAHAM REGIONAL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Mrs. Jill Denice Heinrich, RN, BSN
Title
Administrator
Phone
(928) 428-5668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA-210 AZ Primary

Addresses

Primary practice location

1600 S. 20TH Ave., BLDG. E
Safford, AZ 85546

Mailing address

1600 S. 20TH Ave., BLDG. E
Safford, AZ 85546
Phone (928) 428-5668

Other identifiers 3

IdentifierTypeStateIssuer
HHA-210OtherAZADHS NUMBER
03D0886073OtherAZCLIA NUMBER
317786MedicaidAZ

Other names 1

  • Mt Graham Home Health Other name

National Provider Directory

National Provider Directory
Part of
Mt Graham Communnity Ho

Locations

1600 S 20th Ave
Bldg E
Safford, AZ 85546
Phone (928) 348-4047

Practitioners & affiliated clinicians

Practitioners 37

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 37

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1659337848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S. 20TH AVE., BLDG. E",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "85546",
            "telephone_number": "928-428-5668",
            "fax_number": "928-348-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S. 20TH AVE., BLDG. E",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "85546",
            "telephone_number": "928-428-5668",
            "fax_number": "928-348-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT GRAHAM REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MT GRAHAM REGIONAL MEDICAL CENTER INC",
        "enumeration_date": "2006-04-25",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "HEINRICH",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "DENICE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "928-428-5668",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "HHA-210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADHS NUMBER",
            "identifier": "HHA-210",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "03D0886073",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317786",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mt Graham Home Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Safford, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.