1. Home
  2. Directory
  3. Arizona
  4. Fort Mohave
  5. Family Medicine
  6. NPI Profile

MOHAVE FAMILY HEALTHCARE
NPI 1043369168
Family Medicine in Fort Mohave, AZ

Active since January 09, 2007CLIA 03D0976882 · Waiver
1611 E JOY LN, FORT MOHAVE, AZ 86426(928) 768-9496(928) 768-1943 Get Directions Write a Review

NPPES record last updated: April 5, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mohave Family Healthcare NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOHAVE FAMILY HEALTHCARE (NPI 1043369168) is a healthcare organization registered as a family medicine in Fort Mohave, Arizona and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through August 15, 2028 and lists William Brian Womack, D.o./owner, as its authorized official.

NPPES Registry Identity

NPI1043369168
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMOHAVE FAMILY HEALTHCARE
Location Address1611 E JOY LNFort Mohave, AZ 86426-8807
Mailing AddressPo Box 9479Fort Mohave, AZ 86427-9479 · (928) 768-9496 · Fax (928) 768-1943
Phone(928) 768-9496
Fax(928) 768-1943
Organization SubpartNo
Authorized OfficialWilliam Brian WomackD.o./owner · (928) 768-9496
Enumeration DateJanuary 9, 2007
Last NPPES UpdateApril 5, 2019
✔ NPI 1043369168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AZ · 3527
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1611 E JOY LN, Fort Mohave, AZ 86426
Open in Google Maps ↗

Other Names 1

Doing Business AsMohave Family Healthcare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mohave Family Healthcare is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Mohave Family Healthcare, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Larry Bousquet, FNP
Nurse Practitioner
NPI 1205544871
1611 E JOY LN # 1
Fort Mohave, AZ 86426
(928) 768-9496
✔ PECOS✔ Accepts MedicareSame address
William Womack, D.O.
Family Practice
NPI 1679678205
1611 JOY LN
Fort Mohave, AZ 86426
(928) 768-9496
✔ PECOSSame address
Diana Mcnally, FNP
Nurse Practitioner
NPI 1144740036
2585 MIRACLE MILE STE 116
Bullhead City, AZ 86442
(928) 704-1221
✔ PECOS✔ Accepts Medicare6.6 mi
Jenny Parker, NP-C
Nurse Practitioner
NPI 1184102097
800 M 139
Benton Harbor, MI 49022
(855) 869-6900
✔ PECOS1,594 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D0976882

Mohave Family Healthcare · Fort Mohave, AZ
Active · expires Aug 15, 2028
CLIA Number03D0976882
Laboratory TypePhysician Office
Certificate Effective DateAugust 16, 2026
Certificate Expiration DateAugust 15, 2028
Laboratory DirectorWilliam B. Womack Do
Laboratory Phone(928) 768-9496
Laboratory LocationMohave Family Healthcare1611 Joy Ln, Fort Mohave, AZ 86426
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mohave Family Healthcare's NPI number?

The NPI number for Mohave Family Healthcare is 1043369168. It was assigned to this organization in the NPPES registry on January 9, 2007.

Where is Mohave Family Healthcare located?

Mohave Family Healthcare is located at 1611 E Joy Ln, Fort Mohave, AZ 86426. The listed phone number is (928) 768-9496.

What is Mohave Family Healthcare's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mohave Family Healthcare enrolled in Medicare?

Yes. Mohave Family Healthcare is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mohave Family Healthcare?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Mohave Family Healthcare. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Family Practice (1). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mohave Family Healthcare hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D0976882) is associated with this NPI, valid through August 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mohave Family Healthcare was last updated on April 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.