NPIMap

Organization Active NPI

Spectrum Healthcare Group, Inc.

  • Community/Behavioral Health Agency
  • Camp Verde, AZ
National Provider Identifier
1952487019
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
BH-2174 Issued in AZ
Legal business name
SPECTRUM HEALTHCARE GROUP, INC.
Practice address
452 W Finnie Flat Rd Ste F
Camp Verde, AZ 86322-7379
Phone
(928) 634-2236
Fax
(928) 634-8960
NPI assigned
Oct 31, 2006
Organization subpart
Yes
Parent organization
SPECTRUM HEALTHCARE GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Corinne Bailey
Title
Credentialing Specialist
Phone
(928) 634-2236

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X BH-2174 AZ Primary

Addresses

Primary practice location

452 W Finnie Flat Rd Ste F
Camp Verde, AZ 86322-7379

Mailing address

452 W Finnie Flats Rd
Camp Verde, AZ 86322-7298
Phone (928) 634-2236

Other identifiers 1

IdentifierTypeStateIssuer
755689MedicaidAZ

Other names 1

  • Verde Valley Guidance Clinic, Inc. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000698 AZ Part B Supplier - Clinic/Group Practice 3072411388 Receives reassigned benefits from 57 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tucson, AZ; Prescott Valley, AZ; Cottonwood, AZ; Prescott, AZ; Phoenix, AZ

Other NPIs on the same Medicare enrollment 21

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

View all 21

National Provider Directory

National Provider Directory
Part of
Verde Vly Guidance Clin

Locations

452 W Finnie Flat Rd
Ste F
Camp Verde, AZ 86322
Phone (776) 347-3338

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1952487019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 W FINNIE FLATS RD",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863227298",
            "telephone_number": "928-634-2236",
            "fax_number": "928-634-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 W FINNIE FLAT RD STE F",
            "city": "CAMP VERDE",
            "state": "AZ",
            "postal_code": "863227379",
            "telephone_number": "928-634-2236",
            "fax_number": "928-634-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM HEALTHCARE GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECTRUM HEALTHCARE GROUP, INC.",
        "enumeration_date": "2006-10-31",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "CORINNE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "928-634-2236"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "AZ",
            "license": "BH-2174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "755689",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Verde Valley Guidance Clinic, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Verde Valley Guidance Clinic, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Camp Verde, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.