Coconino County

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

AP1709 Issued in AZ

Legal business name

COCONINO COUNTY

Practice address

2625 N King St
Clinical Services
Flagstaff, AZ 86004-1884

Phone

(928) 679-7222

Fax

(928) 679-7351

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Sarah Schildecker

Title

Division Manager

Phone

(928) 679-7377

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Coconino County Health Department

  • Public Health or Welfare Agency
  • Flagstaff, AZ
  • NPI 1659498848

  O20071231000514

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Coconino County HHS5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Coconino County Health Department

  • Public Health or Welfare Agency
  • Flagstaff, AZ
  • NPI 1629379136
  NPD tax ID
• Coconino County Health Department

  • Public Health or Welfare Agency
  • Flagstaff, AZ
  • NPI 1659498848
  NPD tax ID
• Coconino County HHS

  • Counselor
  • Flagstaff, AZ
  • NPI 1669073870
  NPD tax ID
• Coconino County Juvenile Courts

  • Mental Health Counselor
  • Flagstaff, AZ
  • NPI 1194328450
  NPD tax ID

Locations

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1962529610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 N KING ST",
            "address_2": "CLINICAL SERVICES",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041884",
            "telephone_number": "928-679-7222",
            "fax_number": "928-679-7351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 N KING ST",
            "address_2": "CLINICAL SERVICES",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041884",
            "telephone_number": "928-679-7222",
            "fax_number": "928-679-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COCONINO COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "SCHILDECKER",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "DIVISION MANAGER",
        "authorized_official_telephone_number": "928-679-7377"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "AZ",
            "license": "AP1709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062224",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "URL",
            "affiliation": "N",
            "address_1": "2625 N King St",
            "address_2": "Clinical Services",
            "city": "Flagstaff",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "860041884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Travis Jason Clevy
• Susann Ann Clinton, FNP
• Susan Jane Clow, COTA/L
• Laurice P Coats, MD
• Lydia Louise Cockayne, RDH
• Coconino County Health Department
• Coconino County Health Department
• Coconino County HHS
• Coconino County Juvenile Courts
• Coconino Health and Wellness Center LLC

• All providers in Flagstaff, AZ
• Public Health or Welfare Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.