FORT DEFIANCE INDIAN HOSPITAL BOARD, INC (NPI# 1366993636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366993636 |
| Entity Type | Organization |
| Organization Name | FORT DEFIANCE INDIAN HOSPITAL BOARD, INC |
| Other Organization Name | TSEHOOTSOOI MEDICAL CENTER |
| Practice Address |
Corner of Route N12 and N7 Fort Defiance Indian Hospital Board, Inc Fort Defiance AZ 86504-0589 |
| Mailing Address |
P.o. Box 589 Fort Defiance Indian Hospital Board, Inc. Fort Defiance AZ 86504 |
| Practice Telephone | 9282798000 |
| Mailing Telephone | 9282798000 |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-10-20 |
| Authorized Official Name | SANDI ARINTINO (CEO) |
| Authorized Official Telephone | 9287298902 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
MD2012-0766 | NM | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 1982915443 | 05 |
| Other Name | Type Code |
|---|---|
| Tsehootsooi Medical Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679876551 | Fort Defiance Indian Hospital Board, Inc | General Acute Care Hospital | Nw Corner of Navajo Rt. 12 and 7, Fort Defiance, AZ 86504 | 2010-12-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | FORT DEFIANCE INDIAN HOSPITAL BOARD, INC. | Corner of N12 & N7, Fort Defiance, AZ 86504 |
| Street Address |
CORNER OF ROUTE N12 AND N7 FORT DEFIANCE INDIAN HOSPITAL BOARD, INC |
| City | FORT DEFIANCE |
| State | AZ |
| Zip Code | 86504-0589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326040577 | John R Thompson | Orthopaedic Surgery | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2005-06-01 |
| 1194348524 | Shanna Michelle George | Respiratory Therapist, Registered | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0589 | 2020-05-20 |
| 1265077267 | Stanislava Manojlovic | Pharmacist | Corner of Route N12 and N7, Fort Defiance Indian Hospital Board, Inc., Fort Defiance, AZ 86504-0649 | 2019-11-13 |
| 1033767371 | Dakota Kay | Physical Therapist | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-08-29 |
| 1053964452 | Jenny Dietz | Nurse Practitioner | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2019-07-24 |
| 1386296648 | Tessa Tahereh Facer | Physician Assistant | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-07-16 |
| 1346892056 | Amanda Barnes | Physician Assistant | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2019-07-12 |
| 1295206779 | Craig Amidon Fox | Physical Therapist | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-12-10 |
| 1134698517 | Christa Lee | Advanced Practice Midwife | Corner of Route N12 and N7, Fort Defiance, AZ 86504-0649 | 2018-11-15 |
| 1518440007 | Ethan Curleyhair | Dentist | Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-09-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807664 | Clifford Charles | Pharmacist | Corners of Route 7&12, Fort Defiance, AZ 86504 | 2020-10-06 |
| 1720605207 | Christopher A Will | Registered Nurse | 2126-1 Shandiin Circle, Fort Defiance, AZ 86504 | 2020-06-30 |
| 1750904207 | Crystal Salaz | Respiratory Therapist, Registered | Corner of Roue N12 and N7, Fort Defiance, AZ 86504 | 2020-05-19 |
| 1003451600 | Rebecca Reeve | Pharmacist | Tsehootsooi Medical Center, Corner of Indian Route 7 and 12, Fort Defiance, AZ 86504 | 2019-11-07 |
| 1851947485 | David Glen Webb | Pharmacist | Hwy 12 Nr 110, Fort Defiance, AZ 86504 | 2019-08-09 |
| 1952963647 | Eukerison Bobby Tsinajinie | Counselor | .25 Miles S Fieldhouse Ra 6905, Fort Defiance, AZ 86504 | 2019-07-02 |
| 1770145567 | Joann Tso I | Counselor | 1/4 Mile Ne of Ft. Defiance Fieldhouse, Ft. Defiance, AZ 86504 | 2019-07-02 |
| 1174185961 | James Leslie | Counselor | 1/4 Mile South of Ft Defiance Fieldhouse Ra#6905, Ft Defiance, AZ 86504 | 2019-07-02 |
| 1184192163 | Miranda Frances Blatchford | Social Worker | .5 Miles Sw of The Fd Field House, Bldg #6905, Fort Defiance, AZ 86504 | 2018-11-07 |
| 1477030914 | Michelle Rosario | Dietitian, Registered | Fort Defiance Indian Hospital Board, Inc., Corner of Route N12 and N7, Fort Defiance, AZ 86504 | 2018-07-27 |
| Find all providers in zip 86504 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
| City | FORT DEFIANCE |
| Zip Code | 86504 |
Please comment or provide details below to improve the information on FORT DEFIANCE INDIAN HOSPITAL BOARD, INC.
| 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.