NPIMap

Organization Active NPI

Native Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Phoenix, AZ
National Provider Identifier
1780121244
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NATIVE HEALTH
Practice address
4041 N Central Ave BLDG C
Phoenix, AZ 85012-3313
Phone
(602) 279-5262
Fax
(602) 279-5390
NPI assigned
Jan 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Authorized official

Name
Walter Murillo
Title
Ceo
Phone
(602) 279-5262

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

4041 N Central Ave BLDG C
Phoenix, AZ 85012-3313

Mailing address

4041 N Central Ave BLDG C
Phoenix, AZ 85012-3313
Phone (602) 279-5262

Other practice location 1

777 W Southern Ave
Bldg E, Ste 501
Mesa, AZ 85210
Phone (480) 550-4048

Other practice location 2

8800 N 22nd Ave
Phoenix, AZ 85021-4258
Phone (602) 279-5351

Other identifiers 1

IdentifierTypeStateIssuer
479794MedicaidAZ

Other names 1

  • Native American Community Health Center, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070920000529 AZ Part A Provider - Federally Qualified Health Center (FQHC) 4385738418 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ
O20180319001101 AZ Part B Supplier - Clinic/Group Practice 4385738418 Receives reassigned benefits from 24 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Guadalupe, AZ; Mesa, AZ; Phoenix, AZ
O20190418001393 AZ Part A Provider - Federally Qualified Health Center (FQHC) 4385738418 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ

Federally qualified health center certification: CCN 031879

Legal name
NATIVE HEALTH
Doing business as
NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 27, 2009
Last certification
Oct 27, 2009
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1997 in AZ
Enrollment address
2423 W Dunlap Ave
Ste 140
Phoenix, AZ 85021-5818

Federally qualified health center certification: CCN 031825

Legal name
NATIVE HEALTH
Doing business as
NATIVE AMERICAN COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 1, 1996
Last certification
Jul 1, 1996
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1997 in AZ
Enrollment address
4041 N Central Ave
BLDG C
Phoenix, AZ 85012-3313

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Locations

777 W Southern Ave
Bldg Bc
Mesa, AZ 85210

6850 W Indian School Rd
Phoenix, AZ 85033
Phone (623) 247-0464

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Cody Nelson Individual Operational/Managerial ControlCfo Oct 1, 2018
Corporate OfficerChief Financial Officer Oct 1, 2018
Olivia Wauneka Individual Corporate DirectorBoard Member Jun 18, 2019
John Molina Individual Corporate OfficerCompliance Officer Jan 12, 2017
Brianna Jajelski Individual Corporate DirectorBoard Member Jun 18, 2019
Christina Brown Individual Corporate DirectorBoard Member Jun 1, 2018
Carol Dahozy Individual Corporate DirectorBoard Member Jun 1, 2017
Francie Brown-Spencer Individual Corporate OfficerFunds Development Officer Mar 5, 2020
Corporate OfficerChief Development Officer Jan 4, 2024
Native Health Organization, Phoenix, AZ Corporation, Non-profit Operational/Managerial Control Aug 30, 1978
Deanna Sangster Individual Corporate OfficerCoo May 13, 2021
Corporate OfficerChief Operating Officer Aug 13, 1992
Jeanine Edaakie Individual Corporate DirectorBoard Member Jun 1, 2018
Corporate OfficerBoard Vice President Jun 1, 2018
Rishi Popat Individual Corporate DirectorBoard Member Jun 1, 2017
Corporate OfficerBoard Member Jun 1, 2017
Shawn Sellers Individual Corporate DirectorBoard Member Jun 1, 2017
Corporate OfficerBoard President Jun 1, 2017
Tahnisha Sungino Individual Corporate DirectorBoard Member Jun 1, 2018
Walter R Murillo Individual Operational/Managerial ControlCeo May 31, 2011
Corporate OfficerChief Executive Officer Jun 28, 2010
Operational/Managerial ControlChief Executive Officer Jun 28, 2010
Elena Young Individual Corporate DirectorBoard Member Jun 1, 2017
Corporate OfficerBoard Secretary Jun 1, 2017
Mitchell Terry Individual Corporate OfficerChief Compliance Officer Dec 7, 2023
Vafa K Matin Individual Corporate OfficerChief Medical Officer Nov 30, 2023

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1780121244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4041 N CENTRAL AVE BLDG C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123313",
            "telephone_number": "602-279-5262",
            "fax_number": "602-279-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4041 N CENTRAL AVE BLDG C",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123313",
            "telephone_number": "602-279-5262",
            "fax_number": "602-279-5390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 W Southern Ave",
            "address_2": "Bldg E, Ste 501",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "85210",
            "country_code": "US",
            "telephone_number": "480-550-4048",
            "fax_number": "480-264-5099",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8800 N 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850214258",
            "country_code": "US",
            "telephone_number": "602-279-5351",
            "fax_number": "602-279-5361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NATIVE HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "MURILLO",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-279-5262"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "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": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479794",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Native American Community Health Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.