Black Canyon Community Health Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

BLACK CANYON COMMUNITY HEALTH CENTER, INC.

Practice address

385 S Main St
Camp Verde, AZ 86322-7272

Phone

(623) 374-0200

Fax

(623) 374-5576

NPI assigned

Sep 23, 2026

Organization subpart

No

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

Authorized official

Name

Randy Charles Hancock

Title

Ceo

Phone

(623) 374-0200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1700799541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19251 E OASIS DR",
            "city": "BLACK CANYON CITY",
            "state": "AZ",
            "postal_code": "853248878",
            "telephone_number": "623-374-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 S MAIN ST",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863227272",
            "telephone_number": "623-374-0200",
            "fax_number": "623-374-5576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK CANYON COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "HANCOCK",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-374-0200"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.