NPIMap

Organization Active NPI

United Community Health Center-Maria Auxiliadora, Inc.

  • Federally Qualified Health Center (FQHC)
  • Arivaca, AZ
National Provider Identifier
1922050319
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.
Practice address
17388 W 3Rd Street
Arivaca, AZ 85601
Phone
(520) 407-5500
Fax
(520) 407-5990
NPI assigned
May 16, 2006
Reactivated
Jun 18, 2008
Last updated
Jun 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Jon Reardon, MSW, MBA
Title
Chief Executive Officer
Phone
(520) 407-5609

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

17388 W 3Rd Street
Arivaca, AZ 85601

Mailing address

1260 S Campbell Ave
Building 2
Green Valley, AZ 85614-0503
Phone (520) 407-5606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040728001592 AZ Part A Provider - Federally Qualified Health Center (FQHC) 4587634472 Practice locations: Arivaca, AZ
O20040930000548 AZ Part B Supplier - Clinic/Group Practice 4587634472 Receives reassigned benefits from 38 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arivaca, AZ; Vail, AZ; Tucson, AZ; Sahuarita, AZ; Green Valley, AZ; Amado, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922050319. Details of each certification follow.

Federally qualified health center certification: CCN 031804

Legal name
UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Feb 1, 1983 in AZ
Enrollment address
17388 W Third St
Arivaca, AZ 85601-0233

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Rodney Lichtenberger Individual Corporate DirectorPresident of Board Feb 24, 2004
William Praust Individual Corporate DirectorBoard Member Feb 24, 2004
Audrey Reida Individual Corporate DirectorBoard Member Apr 23, 2002
Brenda J Parnell Individual Corporate OfficerChief Financial Officer Dec 13, 2022
Operational/Managerial ControlChief Financial Officer Dec 13, 2022
Ellen Rigli Individual Corporate DirectorBoard Member Sep 4, 2007
Margarita Salcido Individual Corporate DirectorBoard Member Apr 23, 2002
Mary Ann Dobson Individual Corporate DirectorBoard Member Dec 1, 2017
Mary Esparza Individual Corporate DirectorBoard Member Jan 6, 2015
Anne Gresham Individual Corporate DirectorBoard Member Apr 1, 2022
Claudette Pippin Individual Corporate OfficerCeo Interim Oct 22, 2022
Debbie Andrus Individual Corporate DirectorBoard Member Mar 1, 2022

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Three Points ClinicTucson, AZ, CCN 031803 Federally qualified health center Operational/Managerial Control Jan 1, 2004
United Community Health CenterGreen Valley, AZ, CCN 031936 Federally qualified health center Other (100%) Dec 23, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1922050319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 S CAMPBELL AVE",
            "address_2": "BUILDING 2",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856140503",
            "telephone_number": "520-407-5606",
            "fax_number": "520-625-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17388 W 3RD STREET",
            "city": "ARIVACA",
            "state": "AZ",
            "postal_code": "85601",
            "telephone_number": "520-407-5500",
            "fax_number": "520-407-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED COMMUNITY HEALTH CENTER-MARIA AUXILIADORA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2025-06-20",
        "certification_date": "2020-01-29",
        "deactivation_date": "2007-01-04",
        "reactivation_date": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "REARDON",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "520-407-5609",
        "authorized_official_credential": "MSW, MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arivaca, AZ

Sources for this page

Verify at the official NPI Registry.