NPIMap

Organization Active NPI

La Frontera Center, Inc.

  • Clinic/Center
  • Tucson, AZ
National Provider Identifier
1811086432
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
CDC-1877 Issued in AZ
Legal business name
LA FRONTERA CENTER, INC.
Practice address
502 W. 29TH Street
Tucson, AZ 85713-3353
Phone
(520) 884-9920
Fax
(520) 792-0654
NPI assigned
Oct 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Kathy Wells
Title
Coo
Phone
(520) 838-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X CDC-1877 AZ Primary

Addresses

Primary practice location

502 W. 29TH Street
Tucson, AZ 85713-3353

Mailing address

502 W. 29TH Street
Tucson, AZ 85713-3353
Phone (520) 884-9920

Other identifiers 1

IdentifierTypeStateIssuer
534364MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115001022 AZ Part B Supplier - Clinic/Group Practice 0648171330 Receives reassigned benefits from 36 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Locations

502 W 29th St
Tucson, AZ 85713
Phone (520) 838-5600

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811086432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W. 29TH STREET",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857133353",
            "telephone_number": "520-884-9920",
            "fax_number": "520-792-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W. 29TH STREET",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857133353",
            "telephone_number": "520-884-9920",
            "fax_number": "520-792-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA FRONTERA CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "520-838-5501",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "CDC-1877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "534364",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.