NPIMap

Organization Active NPI

DHHS PHS Naihs Fort Defiance Hospital

Doing business as PHS Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
National Provider Identifier
1700962131
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
DHHS PHS NAIHS FORT DEFIANCE HOSPITAL
Doing business as
PHS Fort Defiance Indian Hospital
Practice address
Corner of Route N12 & N7
Fort Defiance, AZ 86504-0649
Phone
(928) 729-8000
Fax
(928) 729-8019
NPI assigned
Oct 27, 2006
Last updated
Feb 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Authorized official

Name
Dr. Franklin R Freeland, ED.D.
Title
Chief Executive Officer
Phone
(928) 729-8010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

Corner of Route N12 & N7
Fort Defiance, AZ 86504-0649

Mailing address

PO Box 649
Corner of Route N12 & N7
Fort Defiance, AZ 86504-0649
Phone (928) 729-8000

Other identifiers 2

IdentifierTypeStateIssuer
H0010MedicaidNM
020488MedicaidAZ

Other names 1

  • PHS FORT DEFIANCE INDIAN HOSPITAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fort Defiance Indian Hosp6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 338

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 338

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1700962131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "address_2": "CORNER OF ROUTE N12 & N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000",
            "fax_number": "928-729-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 & N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000",
            "fax_number": "928-729-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS PHS NAIHS FORT DEFIANCE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "FREELAND",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "928-729-8010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H0010",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020488",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHS FORT DEFIANCE INDIAN HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Defiance, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; 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.