NPIMap

Organization Active NPI

County of Yavapai

Doing business as Community Health Center of Yavapai

  • Public Health or Welfare Agency
  • Cottonwood, AZ
National Provider Identifier
1740306307
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
OTC0367 Issued in AZ
Legal business name
COUNTY OF YAVAPAI
Doing business as
Community Health Center of Yavapai
Practice address
51 Brian Mickelsen Parkway
Cottonwood, AZ 86326-3610
Phone
(928) 639-8132
Fax
(866) 279-8919
NPI assigned
Mar 22, 2007
Last updated
Jun 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Authorized official

Name
Leslie Robin Horton
Title
Executive Director
Phone
(928) 442-5303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X OTC0367 AZ Primary

Addresses

Primary practice location

51 Brian Mickelsen Parkway
Cottonwood, AZ 86326-3610

Mailing address

1090 Commerce Dr
Prescott, AZ 86305-3700
Phone (928) 583-1000

Other names 1

  • Community Health Center of Yavapai Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031204000266 AZ Part B Supplier - Clinic/Group Practice 8921919499 Receives reassigned benefits from 29 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cottonwood, AZ; Ash Fork, AZ; Prescott Valley, AZ; Prescott, AZ
O20100729000207 AZ Part A Provider - Federally Qualified Health Center (FQHC) 8921919499 Practice locations: Cottonwood, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740306307. Details of each certification follow.

Federally qualified health center certification: CCN 031847

Legal name
COUNTY OF YAVAPAI
Doing business as
YAVAPAI COUNTY COMMUNITY HEALTH SERVICES
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 25, 2005
Last certification
Apr 25, 2005
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Enrollment address
51 S Brian Mickelsen Pkwy
Cottonwood, AZ 86326-3610
Related CCNs
031838

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott, AZ
    • NPI 1235256637

    8921919499

    Same PAC ID
  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott Valley, AZ
    • NPI 1336265982

    8921919499

    Same PAC ID
  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott, AZ
    • NPI 1659317022

    8921919499

    Same PAC ID
  • County of Yavapai

    dba Yavapai County Community Health Services

    • Public Health or Welfare Agency
    • Prescott, AZ
    • NPI 1952501389

    8921919499

    Same PAC ID

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Yavapai County Health D6 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.

Locations

51 Brian Mickelsen Pkwy
Cottonwood, AZ 86326
Phone (928) 639-8132

3212 N Windsong Dr
Ste 200
Prescott Vly, AZ 86314
Phone (928) 583-1000

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Prescott Free Clinic Inc Organization, Prescott, AZ Non-profit Other Nov 1, 2002
Tracy Pytlakowski Individual W-2 Managing EmployeeFinance Manger Oct 31, 2016 25%
Sharon Rickman Individual Corporate DirectorDirector Jan 23, 2017 100%
County of Yavapai Organization, Prescott, AZ 5% Or Greater Direct Ownership Interest Sep 1, 2001 100%
Kevin Goss Individual W-2 Managing EmployeeBusiness Manager Sep 27, 2015 25%

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott, AZ
    • NPI 1235256637

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott Valley, AZ
    • NPI 1336265982

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott, AZ
    • NPI 1659317022

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Yavapai

    dba Yavapai County Community Health Services

    • Public Health or Welfare Agency
    • Prescott, AZ
    • NPI 1952501389

    5% Or Greater Direct Ownership Interest

    CMS ownership

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Yavapai County Community Health ServicesPrescott, AZ, CCN 031839 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2001
Yavapai County Community Health ServicesPrescott, AZ, CCN 031838 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2001

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott, AZ
    • NPI 1235256637

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott Valley, AZ
    • NPI 1336265982

    5% Or Greater Direct Ownership Interest

    CMS ownership

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott, AZ
    • NPI 1235256637

    County of Yavapai

    CMS ownership
  • County of Yavapai

    dba Community Health Center of Yavapai

    • Public Health or Welfare Agency
    • Prescott Valley, AZ
    • NPI 1336265982

    County of Yavapai

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780358400000",
    "number": "1740306307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 COMMERCE DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863053700",
            "telephone_number": "928-583-1000",
            "fax_number": "866-323-8458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 BRIAN MICKELSEN PARKWAY",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263610",
            "telephone_number": "928-639-8132",
            "fax_number": "866-279-8919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF YAVAPAI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A",
        "authorized_official_last_name": "HORTON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "ROBIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "928-442-5303"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "AZ",
            "license": "OTC0367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Health Center of Yavapai",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cottonwood, AZ

Sources for this page

Verify at the official NPI Registry.