NPIMap

Organization Active NPI

DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Bloomfield, NM
National Provider Identifier
1760427587
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
DHHS, PHS, NAIHS, SHIPROCK HOSPITAL
Practice address
6 Road 7586
Bloomfield, NM 87413
Phone
(505) 368-6401
Fax
(505) 368-6431
NPI assigned
Jun 17, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Fannessa Comer
Title
Ceo
Phone
(505) 368-6006

Owners & managing parties with NPI records 2

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

Other NPIs on the same Medicare enrollment 4

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

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

Affiliated clinicians 139

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 139

Care Compare: Hospital

Medicare Care Compare
Listed as
Northern Navajo Medical CenterCCN 320059
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Federal
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000809 TX Part B Supplier - Clinic/Group Practice 0749193837 Receives reassigned benefits from 616 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomfield, NM; Toadlena, NM; Teecnospos, AZ; Sanostee, NM; Shiprock, NM
O20100830000949 NM Part A Provider - Hospital 0749193837 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bloomfield, NM; Sanostee, NM; Shiprock, NM; Teecnospos, AZ; Toadlena, NM

Hospital certification: CCN 320059

Legal name
DHHS PHS NAIHS SHIPROCK HOSPITAL
Doing business as
NORTHERN NAVAJO MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Mar 18, 1977
Last certification
Aug 17, 1987
Beds
69
Ownership / control type
Federal
Organization structure
OtherNon-profit
Enrollment address
Hwy 491 North
Shiprock, NM 87420-9998
Other Hospital Practice Location
Hospital subgroups
Acute care, Other

All disclosed owners & managing parties 5

Medicare enrollment files

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

NameRoleSinceShare
DHHS PHS Naihs Shiprock Hospital Organization, Shiprock, NM Operational/Managerial Control Jul 1, 2010
DHHS PHS Navajo Area Indian Health Service Organization, St. Michael, AZ Operational/Managerial Control Jul 1, 2010
Katrina Leslie-Puhuyaoma Individual Corporate OfficerChief Executive Officer Aug 5, 2024
Robina Harvey Individual Corporate OfficerHealth System Administrator Aug 5, 2024
Tanya Deale Individual W-2 Managing EmployeeActing Business Office Manager Nov 9, 2021

National Provider Directory

National Provider Directory

Locations

6 Road 7586
Bloomfield, NM 87413
Phone (505) 368-8015

Specialties & licenses 11

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Non-Surgical Family Planning Clinic/Center 261QF0050X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Multi-Specialty Clinic/Center 261QM1300X
Federal Public Health Clinic/Center 261QP0904X
Podiatric Clinic/Center 261QP1100X
Physical Therapy Clinic/Center 261QP2000X
Radiology Clinic/Center 261QR0200X
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X
Urgent Care Clinic/Center 261QU0200X
General Acute Care Hospital 282N00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

6 Road 7586
Bloomfield, NM 87413

Mailing address

PO Box 160
Attnbusiness Office Manager
Shiprock, NM 87420-0160
Phone (505) 368-6401

Other identifiers 5

NPPES NPI Registry
IdentifierTypeStateIssuer
418188MedicaidAZ
7000000084MedicaidUT
7000000092MedicaidUT
89805MedicaidNM
95017950MedicaidCO

Other names 1

NPPES NPI Registry
  • Dzilth-Na-O-Dith-Hle Health Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 11, 2008.

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1760427587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "address_2": "ATTNBUSINESS OFFICE MANAGER",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "874200160",
            "telephone_number": "505-368-6401",
            "fax_number": "505-368-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ROAD 7586",
            "city": "BLOOMFIELD",
            "state": "NM",
            "postal_code": "87413",
            "telephone_number": "505-368-6401",
            "fax_number": "505-368-6431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS, PHS, NAIHS, SHIPROCK HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "COMER",
        "authorized_official_first_name": "FANNESSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-368-6006"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "418188",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000000084",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000000092",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89805",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95017950",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dzilth-Na-O-Dith-Hle Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomfield, NM

Sources for this page

Verify at the official NPI Registry.