FORT DEFIANCE INDIAN HOSPITAL – NPI #1487977914
Clinic/Center

FORT DEFIANCE INDIAN HOSPITAL is an AHC clinic located in FORT DEFIANCE, AZ. NPPES has assigned the NPI number 1487977914 to FORT DEFIANCE INDIAN HOSPITAL on March 11, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “FORT DEFIANCE INDIAN HOSPITAL” is a dba name, the actual legal business name for this organization is THE FORT DEFIANCE INDIAN HOSPITAL BOARD, INCORPORATION. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on Jan 03, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for FORT DEFIANCE INDIAN HOSPITAL below.

NPI Profile for
THE FORT DEFIANCE INDIAN HOSPITAL BOARD, INCORPORATION

NPI Number
1487977914
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
THE FORT DEFIANCE INDIAN HOSPITAL BOARD, INCORPORATION
Doing Business As (dba): FORT DEFIANCE INDIAN HOSPITAL
Primary location
CORNER OF ROUTE N12 & N7
FORT DEFIANCE, AZ 86504-0649
Phone: (928) 729-8000 Fax: (928) 729-8169
Mailing address
PO BOX 649
FORT DEFIANCE, AZ 86504-0649
Phone: (928) 729-8000 Fax: (928) 729-8169
Organization Subpart
No
Authorized Official
NAOMI YOUNG
CHIEF EXECUTIVE OFFICER
Phone: (928) 729-8013
Updated
Certification Date
Jan 03, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for FORT DEFIANCE INDIAN HOSPITAL

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidAZ523053
medicaidAZ341607
medicaidNMH0010
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.