MARIPOSA COMMUNITY HEALTH CENTER (NPI# 1013523539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013523539 |
| Entity Type | Organization |
| Organization Name | MARIPOSA COMMUNITY HEALTH CENTER |
| Practice Address |
1209 W Target Range Rd Nogales AZ 85621-2466 |
| Mailing Address |
825 N Grand Ave Ste 100 Nogales AZ 85621-1061 |
| Practice Telephone | 5202811550 |
| Practice Fax Number | 5202811112 |
| Mailing Telephone | 5207612128 |
| Mailing Fax Number | 5202811112 |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | DANIEL PREVOST (CHIEF OPERATIONS OFFICER) |
| Authorized Official Telephone | 5207612128 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARIPOSA COMMUNITY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mariposa Nogales West | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366050536 | Mariposa Community Health Center | Pharmacy | 1103 Circulo Mercado, Rio Rico, AZ 85648-6248 | 2020-07-14 |
| 1578922787 | Mariposa Community Health Center | Family Medicine | 2239 E Frontage Rd, Tubac, AZ 85646-9777 | 2016-02-16 |
| 1104122563 | Mariposa Community Health Center | Registered Nurse | 1835 N Mastick Way, Nogales, AZ 85621-1064 | 2011-02-02 |
| 1013213404 | Mariposa Community Health Center | Dentist | 1103 Circulo Mercado Ste E, Rio Rico, AZ 85648-6249 | 2011-02-01 |
| 1003837618 | Mariposa Community Health Center | Registered Nurse | 101 Taylor Street, Patagonia, AZ 85624-0645 | 2006-07-21 |
| 1013276161 | Mariposa Community Health Center | Radiology | 1852 N Mastick Way, Nogales, AZ 85621-1063 | 2012-05-10 |
| 1417985474 | Mariposa Community Health Center | Registered Nurse | 1852 N Mastick Way, Nogales, AZ 85621-1063 | 2006-06-29 |
| Street Address |
1209 W TARGET RANGE RD |
| City | NOGALES |
| State | AZ |
| Zip Code | 85621-2466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447242300 | Oscar I Rojas | Pediatrics | 1209 W Target Range Rd, Suite 103, Nogales, AZ 85621-2466 | 2005-08-17 |
| 1922418979 | Jared Ryan Lunkenheimer | Family Medicine | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2014-04-29 |
| 1225479868 | Lydia H. Rivera | Nurse Practitioner | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2013-07-11 |
| 1457604506 | Martha Veronica Borbon | Nurse Practitioner | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2012-10-25 |
| 1023387958 | Valley Ent, PC | Otolaryngology | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2011-12-21 |
| 1396823829 | John Pettit | Surgery | 1209 W Target Range Rd, Suite 4, Nogales, AZ 85621-2465 | 2006-11-01 |
| 1306864145 | Leo Gaston Stinnett Jr. | Surgery | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-07-18 |
| 1811930423 | Jeffrey Thomas Maudlin | Family Medicine | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-06-13 |
| 1861469389 | Miriam E Downey | Nurse Practitioner | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-03-02 |
| 1679552749 | Maria Gwen Gallegos | Nurse Practitioner | 1209 W Target Range Rd, Nogales, AZ 85621-2466 | 2006-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548771033 | Intermountain Health Center, Inc. | Community/Behavioral Health | 272 West Viewpoint Drive, Nogales, AZ 85621 | 2017-10-24 |
| 1336696657 | Intermountain Centers for Human Development Inc. | Community/Behavioral Health | 276 West View Point Drive, Nogales, AZ 85621 | 2016-09-02 |
| 1831584291 | Helping Ourselves Pursue Enrichment, Inc. | Community/Behavioral Health | 1857 N Mastick Way, Nogales, AZ 85621 | 2015-04-02 |
| 1043504376 | Community Intervention Associates | Community/Behavioral Health | 32 Blvd Del Rey David, Nogales, AZ 85621 | 2011-06-03 |
| 1568782175 | Arizona's Children Association | Clinic/Center | 1740 N. Mastick Way, Suite D, Nogales, AZ 85621 | 2010-06-04 |
| 1811032493 | Susan M. Jaworski | Local Education Agency (LEA) | 315 Plum Street, Nogales, AZ 85621 | 2007-02-21 |
| 1194885905 | Alex Gracia | Pharmacy Technician | 839 W. Calle Chico, Nogales, AZ 85621 | 2006-12-11 |
| 1982716130 | Yvette Denise Braun | Chiropractor | 1821 N Mastick Way #1, Nogales, AZ 85621 | 2006-08-31 |
| 1043254154 | John Diaz | Emergency Medicine | 1171 W Target Range Road, Carondelet Holy Cross Hospital, Nogales, AZ 85621 | 2006-06-16 |
| 1467495085 | Bart L Mc Rae | Emergency Medicine | Carondelet Holy Cross Hospital, 1171 W. Target Range Road, Nogales, AZ 85621 | 2006-06-13 |
| Find all providers in zip 85621 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831730795 | El Rio Santa Cruz Neighborhood Health Center, Inc | Clinic/Center | 434 E University Blvd, Tucson, AZ 85705 | 2019-10-02 |
| 1710462593 | Chiricahua Community Health Centers, Inc | Clinic/Center | 310 Arizona St, Bisbee, AZ 85603-1502 | 2018-09-27 |
| 1811472665 | Chiricahua Community Health Centers, Inc | Clinic/Center | 1151 16th Street, Douglas, AZ 85607 | 2018-09-27 |
| 1194207878 | Valle Del Sol, Inc. | Clinic/Center | 1510 S 19th Dr, Phoenix, AZ 85009-6540 | 2018-08-30 |
| 1861970139 | Horizon Health and Wellness, Inc. | Clinic/Center | 374 W Alden Rd, Kearny, AZ 85137-1208 | 2018-07-30 |
| 1578059168 | Native Health | Clinic/Center | 6850 W Indian School Rd Ste Nh1, Phoenix, AZ 85033-3249 | 2018-07-06 |
| 1821582529 | Chiricahua Community Health Centers, Inc | Clinic/Center | 335 South Ocotillo Avenue, Benson, AZ 85602 | 2018-06-18 |
| 1881198992 | Valle Del Sol, Inc. | Clinic/Center | 334 W 10th Pl Ste 100, Mesa, AZ 85201-3499 | 2018-03-22 |
| 1841706785 | Circle The City | Clinic/Center | 206 S 12th Ave, Phoenix, AZ 85007 | 2017-12-14 |
| 1346755295 | Circle The City | Clinic/Center | 210 S 12th Ave, Phoenix, AZ 85007-3101 | 2017-12-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.