TRI STATE PRIMARY CARE
NPI 1669146536
Internal Medicine in Fort Mohave, AZ
About Tri State Primary Care NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRI STATE PRIMARY CARE (NPI 1669146536) is a healthcare organization registered as an internal medicine in Fort Mohave, Arizona and active in the NPI registry since August 2021. The organization lists Wantzy Cooper, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tri State Primary Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Tri State Primary Care, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Colorado River Primary Care, Inc's NPI number?
The NPI number for Colorado River Primary Care, Inc is 1669146536. It was assigned to this organization in the NPPES registry on August 4, 2021. The provider is doing business as Tri State Primary Care.
Where is Colorado River Primary Care, Inc located?
Colorado River Primary Care, Inc is located at 1510 E Wagon Wheel Ln Ste 104, Fort Mohave, AZ 86426. The listed phone number is (928) 248-0518.
What is Colorado River Primary Care, Inc's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Colorado River Primary Care, Inc enrolled in Medicare?
Yes. Colorado River Primary Care, Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Colorado River Primary Care, Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Colorado River Primary Care, Inc, in Cardiovascular Disease (Cardiology), Family Practice, Internal Medicine and Vascular Surgery. 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. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Colorado River Primary Care, Inc was last updated on March 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Tri State Primary Care · NPI 1669146536
Internal Medicine organization in Fort Mohave, Arizona. Organization record, active in the CMS NPPES registry since August 4, 2021.
## Identity
- **NPI:** 1669146536 (Entity type: Organization)
- **Enumerated:** August 4, 2021
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Colorado River Primary Care, Inc
- **Organization subpart:** No
- **Authorized official:** Wantzy Cooper, PRESIDENT
## Practice location
- **Address:** 1510 E WAGON WHEEL LN STE 104, Fort Mohave, AZ 86426-6698
- **Phone:** (928) 248-0518 · **Fax:** (928) 514-2823
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Cardiovascular Disease (Cardiology) (1), Family Practice (1), Internal Medicine (1); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 4, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1669146536) · Data from the CMS NPPES public registry.