NPIMap

Organization Active NPI

Cobre Valley Regional Medical Center

Doing business as Cobre Valley Family Practice

  • Rural Health Clinic/Center
  • Globe, AZ
National Provider Identifier
1962896167
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
RGH0126 Issued in AZ
Legal business name
COBRE VALLEY REGIONAL MEDICAL CENTER
Doing business as
Cobre Valley Family Practice
Practice address
5860 S Hospital Dr Ste 103
Globe, AZ 85501-9449
Phone
(928) 425-7108
Fax
(928) 425-7925
NPI assigned
Mar 25, 2015
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Neal D Jensen
Title
Ceo
Phone
(928) 402-1131

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Rural Health Clinic/Center 261QR1300X RGH0126 AZ Primary

Addresses

Primary practice location

5860 S Hospital Dr Ste 103
Globe, AZ 85501-9449

Mailing address

5880 S Hospital Dr
Globe, AZ 85501-9447
Phone (928) 425-3261

Other names 1

  • Cobre Valley Family Practice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040312001228 AZ Part B Supplier - Clinic/Group Practice 0648181693 Receives reassigned benefits from 69 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Young, AZ; Tonto Basin, AZ; Kearny, AZ; Globe, AZ; Superior, AZ
O20170502001316 AZ Part A Provider - Rural Health Clinic 0648181693 Practice locations: Globe, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962896167. Details of each certification follow.

Rural health clinic certification: CCN 038506

Legal name
COBRE VALLEY REGIONAL MEDICAL CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 7, 2017
Last certification
Mar 14, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Mar 29, 1988 in AZ
Enrollment address
5994 S Hospital Dr
Globe, AZ 85501-9462
Related CCNs
031314

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Cobre Valley Comm Hosp14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jack Bradford Individual Corporate DirectorVice Chairman Jun 23, 2022
Jody Daggett Individual Corporate DirectorChief of Medical Staff (Ex Officio) Jan 20, 2016
Edward Carpenter Individual Corporate DirectorTrustee Oct 24, 2006
Nick Renon Individual Corporate DirectorTrustee Jul 28, 2025
Paula Horn Individual Corporate DirectorSecretary Feb 22, 2024
Neal Duane Jensen Individual Corporate DirectorCeo (Ex Officio) Jul 10, 1998
Alan Osumi Individual Corporate DirectorBoard Member Mar 1, 2015
Robert E Hollis Individual Corporate DirectorTreasurer Jul 20, 2014
Jendean G Sartain Individual Corporate DirectorTrustee Mar 23, 2005
Frank Stapleton Individual W-2 Managing EmployeeChief Clinical Operations Officer Jan 22, 2002
Fernando Shipley Individual Corporate DirectorBoard Member Aug 1, 2004
Judy Bessee Individual Corporate DirectorChairman Feb 28, 2017

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Pleasant Valley Community Medical CenterYoung, AZ, CCN 038500 Rural health clinic 5% Or Greater Direct Ownership Interest Jul 10, 1998

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 7

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": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1962896167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 S HOSPITAL DR",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855019447",
            "telephone_number": "928-425-3261",
            "fax_number": "928-425-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 S HOSPITAL DR STE 103",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855019449",
            "telephone_number": "928-425-7108",
            "fax_number": "928-425-7925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBRE VALLEY REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-402-1131"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "AZ",
            "license": "RGH0126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cobre Valley Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Globe, AZ

Sources for this page

Verify at the official NPI Registry.