Community Hospital Association, Inc.
Organization Active NPI Rehabilitation Clinic/Center · Bagdad, AZ
NPI 1730445347 · NPPES record last updated Apr 9, 2012
Key facts
- NPI
- 1730445347
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rehabilitation Clinic/Center 261QR0400X
- Legal business name
- COMMUNITY HOSPITAL ASSOCIATION, INC.
- Practice address
- 700 Palo Verde Road
Bagdad, AZ 86321 - Phone
- (928) 633-6393
- NPI assigned
- Apr 9, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. James R Smith, CPA
- Title
- Cfo
- Phone
- (928) 684-4390
Other NPIs on the same Medicare enrollment 4
Corporate family (same tax ID) 7
Practitioners 6
-
Krista Janiszewski Bauer, MSN, FNP-C, WCC, OMS
-
Courtney Lyn Neal, MSN, APRN, FNP-C
-
Mitchell Wagner, MD
-
Sharon E Manchester, PA-C
-
William Gerard Welker Jr., MS, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040616001475 | AZ | Part B Supplier - Clinic/Group Practice | 4981688900 |
Receives reassigned benefits from 42 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wittmann, AZ; Wickenburg, AZ; Congress, AZ; Bagdad, AZ |
National Provider Directory
- Tax ID family
- Community Hospital Assoc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Clinic/Center | 261QR0400X | Yes |
Addresses
Primary practice location
700 Palo Verde Road
Bagdad, AZ 86321
Mailing address
520 Rose LN
Wickenburg, AZ 85390-1447
Phone (928) 684-4390
Other names
- Physical Therapy - Bagdad
Other providers in Bagdad, AZ
- Bagdad Consulting Physicians Group
- John Arthur Buckman
- Gary Crandell
- Christal Garza
- Lacey Taylor Parkman
- Shahrokh NMN Salmasi
All providers in Bagdad, AZ · Rehabilitation Clinic/Center in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.