NPIMap

Organization Active NPI

Community Healthcare of Douglas Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Douglas, AZ
National Provider Identifier
1932300910
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
H-0015 Issued in AZ
Legal business name
COMMUNITY HEALTHCARE OF DOUGLAS INC
Practice address
2174 W Oak Ave
Douglas, AZ 85607-6003
Phone
(520) 364-7931
Fax
(520) 364-2551
NPI assigned
May 29, 2007
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
Michael J Carter, PH.D.
Title
Chief Executive Officer
Phone
(520) 364-7931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X H-0015 AZ Primary

Addresses

Primary practice location

2174 W Oak Ave
Douglas, AZ 85607-6003

Mailing address

2174 W Oak Ave
Douglas, AZ 85607-6003
Phone (520) 364-7931

Other names 1

  • Southeast Arizona Medical Center Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932300910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2174 W OAK AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856076003",
            "telephone_number": "520-364-7931",
            "fax_number": "520-364-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2174 W OAK AVE",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856076003",
            "telephone_number": "520-364-7931",
            "fax_number": "520-364-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTHCARE OF DOUGLAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "520-364-7931",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "AZ",
            "license": "H-0015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Arizona Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Douglas, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.