| NPI | 1104122563 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2011-02-02 |
| Last Updated | 2025-02-10 |
| Authorized Official | Amy Taylor Chief Executive Officer Phone: 5207612128 |
| Mailing Address | 825 N Grand Ave Ste 100 Nogales, AZ 85621-2385 United States Phone: (520) 761-2128 | Fax: (520) 281-1112 📍 View Map |
| Primary Practice Address | 1835 N Mastick Way Nogales, AZ 85621-1064 United States Phone: (520) 281-1550 | Fax: (520) 281-4487 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | AZ | 03-1884 | Medicare Part A Group # |
| MEDICAID | AZ | 931890 | — |
| Other (non-Medicare) | AZ | ZFQ03-1884 | Medicare Part B Group # |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 163W00000X – Registered Nurse | — | — |
| No | 164W00000X – Licensed Practical Nurse | — | — |
| No | 207Q00000X – Family Medicine | — | — |
| No | 207R00000X – Internal Medicine | — | — |
| No | 207V00000X – Obstetrics & Gynecology | — | — |
| No | 208000000X – Pediatrics | — | — |
| No | 208D00000X – General Practice | — | — |
| Yes | 261QF0400X – Clinic/Center, Federally Qualified Health Center (FQHC) | — | — |
| No | 363A00000X – Physician Assistant | — | — |
| No | 363L00000X – Nurse Practitioner | — | — |
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About NPI 1104122563
Mariposa Community Health Center, Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1104122563. The primary specialty listed is Clinic/Center, Federally Qualified Health Center (FQHC). The organization is located in Nogales, AZ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2011-02-02. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1104122563?
NPI 1104122563 belongs to Mariposa Community Health Center, Inc, a Clinic/Center, Federally Qualified Health Center (FQHC) in Nogales, AZ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1104122563 active?
The current status of NPI 1104122563 in the NPPES registry is Active. The record was last updated on 2025-02-10.
What specialty is NPI 1104122563?
NPI 1104122563 is classified under the taxonomy Clinic/Center, Federally Qualified Health Center (FQHC). Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1104122563?
You can verify NPI 1104122563 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1104122563?
The primary practice address on file for NPI 1104122563 is 1835 N Mastick Way, Nogales, AZ 85621-1064. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1104122563 issued?
NPI 1104122563 was first issued (enumerated) on 2011-02-02. The NPPES record was last updated on 2025-02-10.
Practice Location Map
Mariposa Community Health Center, Inc is located at 1835 N Mastick Way, Nogales, AZ. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Mariposa Community Health Center, Inc. All records sourced from the CMS NPPES registry.