NPIMap

Organization Active NPI

Changepoint Integrated Health

Doing business as changePoint Integrated Health Snowflake Vision Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Snowflake, AZ
National Provider Identifier
1952891970
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
OTC8913 Issued in AZ
Legal business name
CHANGEPOINT INTEGRATED HEALTH
Doing business as
changePoint Integrated Health Snowflake Vision Center
Practice address
537 S Main St
Snowflake, AZ 85937-5279
Phone
(928) 537-5315
Fax
(928) 892-5828
NPI assigned
May 15, 2018
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
CHANGEPOINT INTEGRATEDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Michele A Hospodka
Title
Billing and Credentialing Specialis
Phone
(928) 537-5315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X OTC8913 AZ Primary

Addresses

Primary practice location

537 S Main St
Snowflake, AZ 85937-5279

Mailing address

1801 W Deuce of Clubs Ste 100
Show Low, AZ 85901-2704
Phone (928) 537-5315

Other names 1

  • changePoint Integrated Health Snowflake Vision Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625001074 AZ Part B Supplier - Clinic/Group Practice 8123004587 Receives reassigned benefits from 36 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winslow, AZ; Snowflake, AZ; Pinetop, AZ; Show Low, AZ; Holbrook, AZ; Lakeside, AZ

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Part of
Community Counseling Centers Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1952891970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W DEUCE OF CLUBS STE 100",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859012704",
            "telephone_number": "928-537-5315",
            "fax_number": "928-892-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 S MAIN ST",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "859375279",
            "telephone_number": "928-537-5315",
            "fax_number": "928-892-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGEPOINT INTEGRATED HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHANGEPOINT INTEGRATED",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "HOSPODKA",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING AND CREDENTIALING SPECIALIS",
        "authorized_official_telephone_number": "928-537-5315"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AZ",
            "license": "OTC8913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "changePoint Integrated Health Snowflake Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snowflake, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.