COPPER QUEEN MEDICAL ASSOCIATES DOUGLAS
NPI 1942217088
Clinic/Center in Douglas, AZ
NPI Status: Active since August 02, 2006
Contact Information
100 E 5TH ST
DOUGLAS, AZ
ZIP 85607
Phone: (520) 364-7659
Fax: (520) 364-8541
- Organization
- Clinic/Center
- Accepts Insurance
- CLIA Number: 03D2124326
- CLIA Cert. Type: Other - FREESTANDING ER
- CLIA Exp. Date: 06-20-2026
About COPPER QUEEN MEDICAL ASSOCIATES DOUGLAS
This page provides the complete NPI Profile along with additional information for Copper Queen Medical Associates Douglas, a provider established in Douglas, Arizona operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1942217088 assigned on August 2006. The practitioner's primary taxonomy code is 261Q00000X with license number OTC-3364 (AZ). The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Ms. Betty Jo Carrizoza (Office Manager)
- NPI
- 1942217088
- Provider Name
- COPPER QUEEN MEDICAL ASSOCIATES DOUGLAS
- Entity Type
- Organization
- Location Address
- 100 E 5TH ST DOUGLAS, AZ 85607
- Location Phone
- (520) 364-7659
- Location Fax
- (520) 364-8541
- Mailing Address
- 100 E 5TH ST DOUGLAS, AZ 85607
- Mailing Phone
- (520) 364-7659
- Mailing Fax
- (520) 364-8541
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-02-2006
- Last Update Date
- 08-08-2008
- Code Navigator
Location Map
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
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- License No.
- OTC-3364
- License State
- AZ
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- AZ Blue ACA StandardHealth Silver with Health Choice - HMO
- AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Bronze Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
- AZ Blue AdvanceHealth Silver Neighborhood (4 Free PCP Visits) - HMO
- AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Gold Neighborhood (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
- AZ Blue EverydayHealth Silver Neighborhood (1 Free PCP Visit) - HMO
- AZ Blue Portfolio Bronze HSA Focus - HMO
- AZ Blue Portfolio Bronze HSA Neighborhood - HMO
- AZ Blue StandardHealth Bronze Focus - HMO
- AZ Blue StandardHealth Bronze Neighborhood - HMO
- AZ Blue StandardHealth Gold Focus - HMO
- AZ Blue StandardHealth Gold Neighborhood - HMO
- AZ Blue StandardHealth Silver Focus - HMO
- AZ Blue StandardHealth Silver Neighborhood - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 03D2124326
- Facility Type
- Other - FREESTANDING ER
- Certificate Effective Date
- June 21, 2024
- Certificate Expiration Date
- June 20, 2026
- Laboratory Director
- MAX MIROT
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Copper Queen Medical Associates Douglas after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1942217088, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 13 providers are registered at the same or a nearby location.
DOUGLAS, AZ 85607
DOUGLAS, AZ 85607
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1942217088, enumerated as an "organization" on August 02, 2006.
The provider is located at 100 E 5TH ST DOUGLAS, AZ 85607 and the phone number is (520) 364-7659.
Clinic/Center with taxonomy code 261Q00000X.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health and Blue. Please consult your insurance carrier or call the provider to verify.
