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BILLY CREEK CLINIC
NPI 1679730493
Clinic/Center - Primary Care in Lakeside, AZ

Active since May 20, 2008CLIA Certified · 2 labs
43 W WHITE MOUNTAIN BLVD, LAKESIDE, AZ 85929(928) 367-4040(928) 367-4042 Get Directions Write a Review

NPPES record last updated: May 27, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Billy Creek Clinic NPPES

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

BILLY CREEK CLINIC (NPI 1679730493) is a healthcare organization registered as a primary care in Lakeside, Arizona and active in the NPI registry since May 2008. The organization holds 2 active CLIA laboratory certificates and lists Jennifer L Larue, Billing, as its authorized official.

NPPES Registry Identity

NPI1679730493
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBILLY CREEK CLINIC
Location Address43 W WHITE MOUNTAIN BLVDLakeside, AZ 85929-7002
Mailing AddressPo Box 878Springerville, AZ 85938-0878 · (928) 333-5333 · Fax (928) 333-5100
Phone(928) 367-4040
Fax(928) 367-4042
Organization SubpartNo
Authorized OfficialJennifer L LarueBilling · (928) 333-5333
Enumeration DateMay 20, 2008
Last NPPES UpdateMay 27, 2008
✔ NPI 1679730493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in AZ · 32794
43 W WHITE MOUNTAIN BLVD, Lakeside, AZ 85929
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA 2

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 03D2012303

Billy Creek Clinic · Lakeside, AZ
Active · expires Aug 31, 2026
CLIA Number03D2012303
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSean P. Wilson
Laboratory Phone(928) 367-4040
Laboratory LocationBilly Creek Clinic43 W White Mtn Blvd, Lakeside, AZ 85929
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2034494

Billy Creek Clinic · Springerville, AZ
Active · expires Dec 26, 2027
CLIA Number03D2034494
Laboratory TypePhysician Office
Certificate Effective DateDecember 27, 2025
Certificate Expiration DateDecember 26, 2027
Laboratory DirectorSean P. Wilson
Laboratory Phone(928) 333-4041
Laboratory LocationBilly Creek Clinic830 E Main St, Ste 110, Springerville, AZ 85938
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WHITE MOUNTAIN PEDIATRICS, PC
Pediatrics
43 W WHITE MOUNTAIN BLVD, SUITE B
LAKESIDE, AZ 85929
Navajo County (928) 367-1300

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 Billy Creek Clinic's NPI number?

The NPI number for Billy Creek Clinic is 1679730493. It was assigned to this organization in the NPPES registry on May 20, 2008.

Where is Billy Creek Clinic located?

Billy Creek Clinic is located at 43 W White Mountain Blvd, Lakeside, AZ 85929. The listed phone number is (928) 367-4040.

What is Billy Creek Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Billy Creek Clinic hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Billy Creek Clinic was last updated on May 27, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.