BLACK CANYON COMMUNITY HEALTH CENTER, INC.
NPI 1679723217
Family Medicine in Black Canyon City, AZ
About Black Canyon Community Health Center, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLACK CANYON COMMUNITY HEALTH CENTER, INC. (NPI 1679723217) is a healthcare organization registered as a family medicine in Black Canyon City, Arizona and active in the NPI registry since September 2008. The organization lists Randy Charles Hancock, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Black Canyon Community Health Center, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Black Canyon Community Health Center, Inc., which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
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 Black Canyon Community Health Center, Inc.'s NPI number?
The NPI number for Black Canyon Community Health Center, Inc. is 1679723217. It was assigned to this organization in the NPPES registry on September 19, 2008.
Where is Black Canyon Community Health Center, Inc. located?
Black Canyon Community Health Center, Inc. is located at 19251 E Oasis Dr, Black Canyon City, AZ 85324. The listed phone number is (623) 374-0200.
What is Black Canyon Community Health Center, Inc.'s specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Black Canyon Community Health Center, Inc. enrolled in Medicare?
Yes. Black Canyon Community Health Center, Inc. is registered in the Medicare PECOS enrollment system.
When is Black Canyon Community Health Center, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Arizona, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Black Canyon Community Health Center, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Black Canyon Community Health Center, Inc., in Family Practice, Mental Health Counselor and Nurse Practitioner. 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 at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Black Canyon Community Health Center, Inc. accept?
Health plans from Ambetter Health and Ambetter from Arizona Complete Health list Black Canyon Community Health Center, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Black Canyon Community Health Center, Inc. was last updated on September 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 42 days 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.
# Black Canyon Community Health Center, Inc. · NPI 1679723217
Family Medicine organization in Black Canyon City, Arizona. Organization record, active in the CMS NPPES registry since September 19, 2008.
## Identity
- **NPI:** 1679723217 (Entity type: Organization)
- **Enumerated:** September 19, 2008
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Randy Hancock, CEO
## Practice location
- **Address:** 19251 E OASIS DR, Black Canyon City, AZ 85324-8878
- **Phone:** (623) 374-0200 · **Fax:** (623) 374-5576
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Arizona, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Mental Health Counselor (1), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 23, 2026
- **Other identifiers:** Medicaid 397607 (AZ)
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Source: [NPI Profile](https://npiprofile.com/npi/1679723217) · Data from the CMS NPPES public registry.