NPIMap

Organization Active NPI

San Carlos Apache Tribe

Doing business as Wellness Center

  • Community/Behavioral Health Agency
  • San Carlos, AZ
National Provider Identifier
1750456307
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SAN CARLOS APACHE TRIBE
Doing business as
Wellness Center
Practice address
#5 San Carlos Ave
San Carlos, AZ 85550-9999
Phone
(928) 475-4875
Fax
(928) 475-4880
NPI assigned
Nov 21, 2006
Last updated
Jul 1, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
SAN CARLOS APACHE TRIBEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Authorized official

Name
Mr. Wendsler A Nosie Sr.
Title
Tribal Chairman
Phone
(928) 475-2361

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 180-004505 IL
Community/Behavioral Health Agency 251S00000X AZ Primary

Addresses

Primary practice location

#5 San Carlos Ave
San Carlos, AZ 85550-9999

Mailing address

PO Box 0
San Carlos, AZ 85550-9999
Phone (928) 475-4875

Other identifiers 1

IdentifierTypeStateIssuer
624230MedicaidAZ

Other names 1

  • Wellness Center Doing business as

National Provider Directory

National Provider Directory
Part of
San Carlos Wellness Center

Practitioners & affiliated clinicians

Practitioners 8

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": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246406400000",
    "number": "1750456307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 0",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "855509999",
            "telephone_number": "928-475-4875",
            "fax_number": "928-475-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#5 SAN CARLOS AVE",
            "city": "SAN CARLOS",
            "state": "AZ",
            "postal_code": "855509999",
            "telephone_number": "928-475-4875",
            "fax_number": "928-475-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN CARLOS APACHE TRIBE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN CARLOS APACHE TRIBE",
        "enumeration_date": "2006-11-21",
        "last_updated": "2009-07-01",
        "status": "A",
        "authorized_official_last_name": "NOSIE",
        "authorized_official_first_name": "WENDSLER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "TRIBAL CHAIRMAN",
        "authorized_official_telephone_number": "928-475-2361",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "180-004505",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "624230",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Carlos, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; 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.