NPIMap

Organization Active NPI

DHHS PHS Naihs Shiprock Hospital

  • Clinical Medical Laboratory
  • Teennospos, AZ
National Provider Identifier
1689804387
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
03D1068558
Legal business name
DHHS PHS NAIHS SHIPROCK HOSPITAL
Practice address
US Hwy 160 & Navajo Route 25 - Red Mesa
Teennospos, AZ 86514
Phone
(928) 656-5000
Fax
(928) 656-5164
NPI assigned
Jul 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
Fannessa Comer
Title
Ceo
Phone
(505) 368-6001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 03D1068558 Primary

Addresses

Primary practice location

US Hwy 160 & Navajo Route 25 - Red Mesa
Teennospos, AZ 86514

Mailing address

HCR 6100, Box 30
Teecnospos, AZ 86514
Phone (928) 656-5000

Other names 1

  • Four Corners Regional Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
DHHS PHS Naihs Shiprock H15 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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1689804387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HCR 6100, BOX 30",
            "city": "TEECNOSPOS",
            "state": "AZ",
            "postal_code": "86514",
            "telephone_number": "928-656-5000",
            "fax_number": "928-656-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 160 & NAVAJO ROUTE 25 - RED MESA",
            "city": "TEENNOSPOS",
            "state": "AZ",
            "postal_code": "86514",
            "telephone_number": "928-656-5000",
            "fax_number": "928-656-5164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS PHS NAIHS SHIPROCK HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-16",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "COMER",
        "authorized_official_first_name": "FANNESSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-368-6001"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": "03D1068558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Corners Regional Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; 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.