NPIMap

Organization Active NPI

DHHS IHS Phoenix Area

Doing business as Parker Indian Hospital

  • Critical Access Hospital
  • Parker, AZ
National Provider Identifier
1851678585
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
Legal business name
DHHS IHS PHOENIX AREA
Doing business as
Parker Indian Hospital
Practice address
12033 Agency Rd
Parker, AZ 85344-7718
Phone
(928) 669-2137
Fax
(928) 669-3232
NPI assigned
Nov 9, 2011
Last updated
Aug 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Traci Halligan
Title
Health System Specialist
Phone
(928) 669-2137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Primary

Addresses

Primary practice location

12033 Agency Rd
Parker, AZ 85344-7718

Mailing address

12033 Agency Rd
Parker, AZ 85344-7718

Other identifiers 5

IdentifierTypeStateIssuer
520131MedicaidAZ
09236201MedicaidAZ
020537MedicaidAZ
P0109720OtherAZBCBS DENTAL
P0201750OtherAZBCBS MEDICAL

Other names 1

  • PARKER INDIAN HOSPITAL Doing business as

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20120105000013 TX Part B Supplier - Clinic/Group Practice 0244405629 Receives reassigned benefits from 200 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Havasu Lake, CA; Parker, AZ
O20131209001149 AZ Part A Provider - Critical Access Hospital 0244405629 Practice locations: Parker, AZ
O20140122001069 AZ Part A Provider - Critical Access Hospital 0244405629 Practice locations: Parker, AZ

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1851678585. Details of each certification follow.

Hospital certification: CCN 031307

Legal name
DHHS IHS PHOENIX AREA
Doing business as
PARKER INDIAN HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 9, 2003
Last certification
Jun 9, 2017
Beds
20
Ownership / control type
Federal
Organization structure
GovernmentNon-profit
Enrollment address
12033 Agency Road
Parker Indian Hospital
Parker, AZ 85344-7718
Other Hospital Practice Location

Hospital certification: CCN 03Z307

Legal name
DHHS IHS PHOENIX AREA
Doing business as
PARKER INDIAN HOSPITAL
Organization structure
GovernmentNon-profit
Enrollment address
12033 Agency Rd
Parker, AZ 85344-7718
Other Hospital Practice Location

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Parker Indian Health CenterCCN 031307 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Federal
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
DHHS IHS Phoenix Area7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

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
DHHS IHS Phoenix Area Organization, Parker, AZ Non-profit Operational/Managerial Control Jan 1, 2010 100%
Operational/Managerial Control Jan 2, 2010 100%
Lilly M Shimahara Individual W-2 Managing EmployeeQuality Reivew Officer and Pract Dec 27, 2017
Perfecto Cronemeyer Individual W-2 Managing EmployeeCoo Dec 27, 2017
Sky Black Elk Volkmann Individual W-2 Managing EmployeeSupervisor, Patient Business Jan 1, 2023
Traci Halligan Individual W-2 Managing EmployeeLead Medical Support Jan 1, 2023

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 190

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.

View all 190

Affiliated clinicians 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1851678585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12033 AGENCY RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853447718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 AGENCY RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853447718",
            "telephone_number": "928-669-2137",
            "fax_number": "928-669-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS IHS PHOENIX AREA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "HALLIGAN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "HEALTH SYSTEM SPECIALIST",
        "authorized_official_telephone_number": "928-669-2137"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "520131",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09236201",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020537",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DENTAL",
            "identifier": "P0109720",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDICAL",
            "identifier": "P0201750",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PARKER INDIAN HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PARKER INDIAN HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parker, AZ

Sources for this page

Verify at the official NPI Registry.