SAN CARLOS INDIAN HOSPITAL
NPI 1538446166
General Acute Care Hospital in Peridot, AZ

NPI Status: Active since November 10, 2011

Contact Information

103 MEDICINE WAY RD
PERIDOT, AZ
ZIP 85542
Phone: (928) 475-1200

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  • Organization
  • General Acute Care Hospital
  • CLIA Number: 03D2274223
  • CLIA Cert. Type: Waiver
  • CLIA Exp. Date: 12-27-2024

About SAN CARLOS INDIAN HOSPITAL

San Carlos Indian Hospital is a provider established in Peridot, Arizona operating as a General Acute Care Hospital. The healthcare provider is registered in the NPI registry with number 1538446166 assigned on November 2011. The practitioner's primary taxonomy code is 282N00000X. The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as San Carlos Indian Hospital. The authorized official of this NPI record is Mrs. Valerie J. Chee (Director - Patient Financial Srvcs)

NPI
1538446166
Provider Legal Name
DHHS IHS PHOENIX AREA
Other Organization Name
SAN CARLOS INDIAN HOSPITAL
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
103 MEDICINE WAY RD PERIDOT, AZ 85542
Location Phone
(928) 475-1200
Mailing Address
PO BOX 787 PERIDOT, AZ 85542
Mailing Phone
(928) 475-1200
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-10-2011
Last Update Date
08-19-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

General Acute Care Hospital

Taxonomy Code
282N00000X
Type
Hospitals
Taxonomy Description
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. VALERIE J. CHEE

Authorized Official Title
DIRECTOR - PATIENT FINANCIAL SRVCS
Authorized Official Phone
(928) 475-1290

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
03D2274223
Facility Type
Other - MOBILE HEALTH UNIT
Certificate Effective Date
December 28, 2022
Certificate Expiration Date
December 27, 2024
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to San Carlos Indian Hospital to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for SAN CARLOS INDIAN HOSPITAL

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1538446166
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25688412112
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 6 + 8 + 8 + 4 + 1 + 2 + 1 + 1 + 2 + 24 = 64
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 64 = 66

The NPI number 1538446166 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 19 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1265929145 FABRICE AFANYU-LORATER RPH.
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1300
1508353301 JULIUS ASOFAR ANUMBOSI
Individual
Pharmacist103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1300
1306336292DR. NATHAN MARC LUNT PHARMD
Individual
Pharmacist103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1300
1689141327DR. LILIANE ABONGWA PHARMD., MBA
Individual
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1304
1417419839 TRACY LE
Individual
Pharmacist103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1300
1467010082 JESSE KUSMULYANA PTA
Individual
Physical Therapy Assistant103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1360
1528416088 GREGORY ELY M.D.
Individual
Emergency Medicine103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1400
1083263354 CHRIS BRIAN GURTLER RN
Individual
Registered Nurse (Community Health)103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1565
1639729429MS. SABRA J VAN ORSDOL BSN,RN,PHN
Individual
Registered Nurse (Community Health)103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1564
1508407909 BRENDA STEVENS
Individual
Registered Nurse (Community Health)103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1567
1043843436 TANISHA DANIELLE MORALES NURSE PRACTITIONER
Individual
Nurse Practitioner (Family)103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1400
1376164293 JASON LAU PHARM.D
Individual
Pharmacist103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1300
1790395192DR. JUSTIN EUGENE CUSHING PHARMD
Individual
Pharmacist103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1300
1295223675 MATHEW MICHAEL BULL
Individual
Internal Medicine103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1400
1275200420 JUDITH-ANN MARIE CHAMBERS
Individual
Pharmacist103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1300
1629710967 SPENCER BIGLER FNP
Individual
Family Medicine103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-7300
1841853777DR. SYLVESTOR A MOSES MD, PHD
Individual
Internal Medicine103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1400
1841720588AKDHC, LLC
Organization
Internal Medicine (Nephrology)103 MEDICINE WAY RD
PERIDOT, AZ 85542
(480) 857-2381
1194220855 BING LI MD
Individual
Emergency Medicine103 MEDICINE WAY RD
PERIDOT, AZ 85542
(928) 475-1400

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538446166, enumerated in the NPI registry as an "organization" on November 10, 2011

The provider is located at 103 Medicine Way Rd Peridot, Az 85542 and the phone number is (928) 475-1200

This medical organization specializes in General Acute Care Hospital with taxonomy code 282N00000X

The provider's CLIA number is 03D2274223 for a "other - mobile health unit" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on November 10, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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