Active NPI
Native Health
Doing business as Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- NATIVE HEALTH
- Doing business as
- Native American Community Health Center, Inc.
- Practice address
- 4041 N Central Ave BLDG C
Phoenix, AZ 85012-3313 - Phone
- (602) 279-5262
- Fax
- (602) 279-5390
- NPI assigned
- Mar 26, 2007
- Last updated
- Oct 7, 2025
- Organization subpart
- Yes
- Parent organization
- NATIVE HEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Walter Murillo
- Title
- Ceo
- Phone
- (602) 279-5262
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NU | Primary |
Addresses
Primary practice location
4041 N Central Ave BLDG C
Phoenix, AZ 85012-3313
Mailing address
4041 N Central Ave BLDG C
Phoenix, AZ 85012-3313
Phone (602) 279-5262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 936933 | Medicaid | AZ |
Other names 1
- Native American Community Health Center, Inc.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180319001101 | AZ | Part B Supplier - Clinic/Group Practice | 4385738418 |
Receives reassigned benefits from 24 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Guadalupe, AZ; Mesa, AZ; Phoenix, AZ |
| O20190418001393 | AZ | Part A Provider - Federally Qualified Health Center (FQHC) | 4385738418 |
3 other NPIs on this enrollment Practice locations: Phoenix, AZ |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1700904075. Details of each certification follow.
Federally qualified health center certification: CCN 031825
- Legal name
- NATIVE HEALTH
- Doing business as
- NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 1, 1996
- Last certification
- Jul 1, 1996
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation
- Incorporated
- Jun 1, 1997 in AZ
- Enrollment address
- 4041 N Central Ave
BLDG C
Phoenix, AZ 85012-3313
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1740462761
4385738418
Other NPIs on the same Medicare enrollment 8
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Mesa, AZ
- NPI 1336654383
O20180319001101
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1427386853
O20180319001101, O20190418001393
-
dba Native American Community Health Center
- Federally Qualified Health Center (FQHC)
- Guadalupe, AZ
- NPI 1487443115
O20180319001101
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1578059168
O20180319001101
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1740462761
O20180319001101, O20190418001393
-
dba Native American Community Health Center, Inc.
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Phoenix, AZ
- NPI 1780121244
O20180319001101, O20190418001393
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1871972182
O20180319001101
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1982830410
O20180319001101
National Provider Directory
National Provider Directory- Tax ID family
- Native Health
- Part of
- Native Health
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Mesa, AZ
- NPI 1336654383
-
dba Native American Community Health Center
- Federally Qualified Health Center (FQHC)
- Guadalupe, AZ
- NPI 1487443115
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1871972182
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1982830410
Locations
777 W Southern Ave
Ste 501
Mesa, AZ 85210
Phone (480) 550-4048
Ownership & related parties
All disclosed owners & managing parties 11
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Cody Nelson | Corporate Officer | Oct 1, 2018 | |
| Francie Brown-Spencer | Corporate Officer | Jan 4, 2024 | |
| Native Health | Operational/Managerial Control | Aug 30, 1978 | |
| Deanna Sangster | Corporate Officer | Aug 13, 1992 | |
| Jeanine Edaakie | Corporate Officer | Jun 1, 2018 | |
| Rishi Popat | Corporate Officer | Jun 1, 2017 | |
| Mitchell Terry | Corporate Officer | Dec 7, 2023 | |
| Shawn Sellers | Corporate Officer | Jun 1, 2017 | |
| Vafa K Matin | Corporate Officer | Nov 30, 2023 | |
| Walter R Murillo | Corporate Officer | Jun 28, 2010 | |
| Operational/Managerial Control | Jun 28, 2010 | ||
| Elena Young | Corporate Officer | Jun 1, 2017 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1740462761
Operational/Managerial Control
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Native American Community Health Center, Inc. | Federally qualified health center | Operational/Managerial Control | Aug 30, 1978 |
Owned or controlled facilities with NPI records 5
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1427386853
Operational/Managerial Control
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1740462761
Operational/Managerial Control
-
dba Native American Community Health Center, Inc.
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Phoenix, AZ
- NPI 1780121244
Operational/Managerial Control
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1871972182
Operational/Managerial Control
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1982830410
Operational/Managerial Control
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Native American Community Health Center, Inc.
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1740462761
Native Health
Practitioners & affiliated clinicians
Practitioners 11
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.
-
- Addiction (Substance Use Disorder) Counselor
- Phoenix, AZ
- NPI 1356147789
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1083243422
-
- Family Nurse Practitioner
- Guadalupe, AZ
- NPI 1902682248
-
- Family Nurse Practitioner
- Phoenix, AZ
- NPI 1780979625
-
- Family Medicine Physician
- Tempe, AZ
- NPI 1447206966
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1184292096
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1184695371
-
- Physician Assistant
- Phoenix, AZ
- NPI 1174698617
-
- Family Nurse Practitioner
- Phoenix, AZ
- NPI 1982390167
-
- Family Nurse Practitioner
- Phoenix, AZ
- NPI 1902207491
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1649856196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759795200000",
"number": "1700904075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4041 N CENTRAL AVE BLDG C",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850123313",
"telephone_number": "602-279-5262",
"fax_number": "602-279-5390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4041 N CENTRAL AVE BLDG C",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850123313",
"telephone_number": "602-279-5262",
"fax_number": "602-279-5390"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NATIVE HEALTH",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "NATIVE HEALTH",
"enumeration_date": "2007-03-26",
"last_updated": "2025-10-07",
"certification_date": "2025-10-07",
"status": "A",
"authorized_official_last_name": "MURILLO",
"authorized_official_first_name": "WALTER",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "602-279-5262",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "936933",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Native American Community Health Center, Inc.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Phoenix, AZ
- Native Family Homecare Inc
- Native Family Treatment Center Inc
- Native Health
- Native Health (Native American Community Health Center, Inc.)
- Native Health (Native American Community Health Center, Inc.)
- Native Health (Native American Community Health Center, Inc.)
- Native Health (Native American Community Health Center, Inc.)
- Native Health (Native Health West Pharmacy)
- Native Health (Native American Community Health Center, Inc.)
- Native Health (Native American Community Health Center, Inc.)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.