COMMUNITY HEALTH CARE OF DOUGLAS (NPI# 1205164688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205164688 |
| Entity Type | Organization |
| Organization Name | COMMUNITY HEALTH CARE OF DOUGLAS |
| Other Organization Name | SOUTHEAST ARIZONA MEDICAL CENTER |
| Practice Address |
2174 W Oak Ave Douglas AZ 85607 |
| Mailing Address |
2174 W Oak Ave Douglas AZ 85607-6003 |
| Practice Telephone | 5208055813 |
| Mailing Telephone | 5208055813 |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2009-11-24 |
| Authorized Official Name | BRIAN BICKELL (CEO) |
| Authorized Official Telephone | 5208055940 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 55843901 | 05 |
| Other Name | Type Code |
|---|---|
| Southeast Arizona Medical Center | Doing Business As Name - Organization |
| Street Address |
2174 W OAK AVE |
| City | DOUGLAS |
| State | AZ |
| Zip Code | 85607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467452623 | Arizona Ambulance of Douglas, Inc. | Ambulance | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2005-07-28 |
| 1073923066 | Douglas Community Hospital, Inc. | General Acute Care Hospital | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2014-04-30 |
| 1992127716 | Douglas Community Hospital | General Acute Care Hospital | 2174 W Oak Ave, Douglas, AZ 85607 | 2014-01-14 |
| 1891070520 | Arizona Em-i Medical Services | Nurse Practitioner | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2011-10-13 |
| 1821386400 | Grand Canyon State Inpatient Services | Hospitalist | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2011-07-15 |
| 1083932784 | Community Healthcare of Douglas Inc. | Clinical Medical Laboratory | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2010-05-06 |
| 1740514207 | Ciara Jane Aparicio | Nurse Practitioner | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2009-09-30 |
| 1023342342 | Saddle Gap Emergency Physicians LLC | Emergency Medicine | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2009-09-21 |
| 1427228212 | Community Healthcare of Douglas | General Acute Care Hospital | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2008-03-07 |
| 1932300910 | Community Healthcare of Douglas Inc | Medicare Defined Swing Bed Unit | 2174 W Oak Ave, Douglas, AZ 85607-6003 | 2007-05-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811472665 | Chiricahua Community Health Centers, Inc | Clinic/Center | 1151 16th Street, Douglas, AZ 85607 | 2018-09-27 |
| 1457758609 | Angela Leah Overturf | Nurse Practitioner | 100 East 5th Street, Douglas, AZ 85607 | 2014-12-02 |
| 1609279108 | Walter Tucker | Counselor | 2100 E 8th, Douglas, AZ 85607 | 2014-09-29 |
| 1851700488 | Gerardo Grijalva | Non-emergency Medical Transport (VAN) | 2714 E 6th St, Douglas, AZ 85607 | 2014-08-07 |
| 1174933246 | Caring Connections for Special Needs, LLC | Community/Behavioral Health | 1019 F Ave, Douglas, AZ 85607 | 2014-04-29 |
| 1831473164 | Cheryl Lynn Mcneeley | Speech-Language Pathologist | 815 E. 15th Street, Douglas, AZ 85607 | 2011-10-05 |
| 1245523364 | Community Intervention Associates | Community/Behavioral Health | 1701 North Douglasave, Douglas, AZ 85607 | 2011-05-23 |
| 1174820898 | Chiricahua Community Health Centers, Inc | Clinic/Center | 815 15th Street, Douglas, AZ 85607 | 2011-02-15 |
| 1033319512 | Community Healthcare of Douglas Inc | Clinic/Center | 1906 11th Street, Douglas, AZ 85607 | 2007-07-23 |
| 1538360888 | Jay Daniel Zamora | Chiropractor | 1915 E 10th St, Douglas, AZ 85607 | 2007-05-31 |
| Find all providers in zip 85607 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396825741 | Open Mri of Douglas LLC | Radiology | 1315 Ocilla Road, Douglas, GA 31533 | 2006-10-17 |
| 1548471030 | Radiology Assoc of South Ga, P.C. | Radiology | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2007-05-25 |
| 1568564128 | Dennis S Yutani | Radiology | 111 S 5th St, Douglas, WY 82633-2434 | 2006-09-03 |
| 1053304428 | Somnuk Pow-anpongkul | Radiology | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2005-08-31 |
| 1013900489 | Nirandr Inthachak | Radiology | 1101 Ocilla Rd, Douglas, GA 31533-2207 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295345783 | Susan Shotts | Radiology | 861 N Higley Rd Ste B101, Gilbert, AZ 85234-9602 | 2020-08-09 |
| 1841840188 | Smsj Imaging Company LLC | Radiology | 630 N Alvernon Way Ste 150, Tucson, AZ 85711-1844 | 2019-09-18 |
| 1417507765 | Smsj Imaging Company LLC | Radiology | 395 N Silverbell Rd Ste 185, Tucson, AZ 85745-2721 | 2019-09-18 |
| 1154971497 | Smsj Imaging Company LLC | Radiology | 400 W Camino Casa Verde Ste 200, Green Valley, AZ 85614-3569 | 2019-09-18 |
| 1740839786 | Smsj Imaging Company LLC | Radiology | 4892 N Stone Ave Ste 180, Tucson, AZ 85704-5761 | 2019-09-11 |
| 1689239824 | Thumb Butte Radiology, LLC | Radiology | 3120 Willow Creek Rd, Prescott, AZ 86301-6699 | 2019-05-02 |
| 1376017020 | Vpa PC | Radiology | 64 E Broadway Rd Ste 200231, Tempe, AZ 85282-1353 | 2019-01-16 |
| 1598243867 | Mdig of Florida, LLC | Radiology | 10835 N 25th Ave Ste 140, Phoenix, AZ 85029-3408 | 2018-07-30 |
| 1689182966 | Faca Vascular | Radiology | 1831 E Queen Creek Rd Ste 120, Chandler, AZ 85286-2019 | 2018-01-20 |
| 1265974836 | Teleradiology Specialists LLC | Radiology | 4813 E Piccadilly Rd, Phoenix, AZ 85018-5540 | 2016-11-13 |
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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.