NPIMap

Organization Active NPI

Tuba City Regional Health Care Corporation

  • Registered Dietitian
  • Tuba City, AZ
National Provider Identifier
1922547223
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
200013 Issued in AZ
Legal business name
TUBA CITY REGIONAL HEALTH CARE CORPORATION
Practice address
167 North Main Street
Tuba City, AZ 86045
Phone
(928) 283-2094
Fax
(928) 283-2677
NPI assigned
Feb 20, 2017
Organization subpart
Yes
Parent organization
TUBA CITY REGIONAL HEALTH CARE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Authorized official

Name
Lynette Bonar
Title
Chief Executive Officer
Phone
(928) 283-2501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X 200013 AZ Primary

Addresses

Primary practice location

167 North Main Street
Tuba City, AZ 86045

Mailing address

PO Box 600
Tuba City, AZ 86045-0600
Phone (928) 283-2094

Other identifiers 1

IdentifierTypeStateIssuer
721250MedicaidAZ

Other names 1

  • Healthy Living Center/Diabetes Treatment & Prevention Services Other name

National Provider Directory

National Provider Directory
Tax ID family
Tuba City Regional Health Care Center39 organizations share this tax ID, including this one
Part of
Tuba City Regional Health Care Center

Other organizations with this tax ID 38

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

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1922547223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "860450600",
            "telephone_number": "928-283-2094",
            "fax_number": "928-283-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 NORTH MAIN STREET",
            "city": "TUBA CITY",
            "state": "AZ",
            "postal_code": "86045",
            "telephone_number": "928-283-2094",
            "fax_number": "928-283-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUBA CITY REGIONAL HEALTH CARE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TUBA CITY REGIONAL HEALTH CARE CORPORATION",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "BONAR",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "928-283-2501"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "200013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "721250",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Living Center/Diabetes Treatment & Prevention Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tuba City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.