Changepoint Integrated Health | |
103 N 1st Ave Holbrook AZ 86025-2817 | |
(928) 537-2951 | |
(928) 892-5828 |
Full Name | Changepoint Integrated Health |
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Speciality | Clinic/Center |
Location | 103 N 1st Ave, Holbrook, Arizona |
Authorized Official Name and Position | Jeffrey Oakes (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 9285372951 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Changepoint Integrated Health 1801 W Deuce Of Clubs Ste 100 Show Low AZ 85901-2704 Ph: (928) 537-2951 | Changepoint Integrated Health 103 N 1st Ave Holbrook AZ 86025-2817 Ph: (928) 537-2951 |
NPI Number | 1205877610 |
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Provider Enumeration Date | 06/08/2006 |
Last Update Date | 09/04/2022 |
Certification Date | 09/04/2022 |
Medicare PECOS PAC ID | 8123004587 |
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Medicare Enrollment ID | O20040625001074 |
Identifier | Type | State | Issuer |
---|---|---|---|
1205877610 | NPI | - | NPPES |
003450 | Other | AZ | AHCCCS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | OTC6041 (Arizona) | Primary |
Provider Name | Marc B Grant |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1700857125 PECOS PAC ID: 1850363771 Enrollment ID: I20040811000544 |
Provider Name | Paul B Tilyou |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1144280009 PECOS PAC ID: 8123046281 Enrollment ID: I20051107000959 |
Provider Name | Judith Carol Engelman |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1518184506 PECOS PAC ID: 1850315680 Enrollment ID: I20060119000829 |
Provider Name | John J Lee |
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Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1568534741 PECOS PAC ID: 9335153881 Enrollment ID: I20060203000413 |
Provider Name | Jeffrey L Moffat |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1962469783 PECOS PAC ID: 2163314725 Enrollment ID: I20060301000698 |
Provider Name | Jeffrey L Schwimmer |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1366545238 PECOS PAC ID: 9436167947 Enrollment ID: I20060324000451 |
Provider Name | Roland Segal |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1972671022 PECOS PAC ID: 2961411590 Enrollment ID: I20060411000100 |
Provider Name | Jacqueline S Hess |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477720530 PECOS PAC ID: 4385685031 Enrollment ID: I20100211000596 |
Provider Name | Edward Gogek |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1124136627 PECOS PAC ID: 8123211554 Enrollment ID: I20101019000099 |
Provider Name | Elisa S Stephens |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730483082 PECOS PAC ID: 8729263298 Enrollment ID: I20110427000047 |
Provider Name | Emina Foci |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568750214 PECOS PAC ID: 1254508872 Enrollment ID: I20120123000843 |
Provider Name | Grace Jackson |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1659460814 PECOS PAC ID: 4183760945 Enrollment ID: I20131022001053 |
Provider Name | Lynn C Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124318159 PECOS PAC ID: 3577885441 Enrollment ID: I20141203001847 |
Provider Name | Ehab Abdallah |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1922112572 PECOS PAC ID: 8224065289 Enrollment ID: I20150225000918 |
Provider Name | Aaron Moyal |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1518050905 PECOS PAC ID: 0547161416 Enrollment ID: I20150325001198 |
Provider Name | Debra Solomon |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1376767707 PECOS PAC ID: 9335239904 Enrollment ID: I20151012000070 |
Provider Name | Madison R Chu |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1861712713 PECOS PAC ID: 4082862040 Enrollment ID: I20151104000912 |
Provider Name | Elena Volfson |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1497710404 PECOS PAC ID: 7719904564 Enrollment ID: I20151211000738 |
Provider Name | Kay Williams |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1942305230 PECOS PAC ID: 3678745650 Enrollment ID: I20161003001417 |
Provider Name | Nathan Shaw |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962931287 PECOS PAC ID: 2769751320 Enrollment ID: I20170713000919 |
Provider Name | Kelvin D Gaskins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497284335 PECOS PAC ID: 5597035543 Enrollment ID: I20170724003102 |
Provider Name | Brian Ellis Paronto |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922501378 PECOS PAC ID: 2062776016 Enrollment ID: I20180430000602 |
Provider Name | Kyle Bart Dewey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477046902 PECOS PAC ID: 2567719982 Enrollment ID: I20180717001381 |
Provider Name | Munachiso Iheonunekwu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922505908 PECOS PAC ID: 3274882352 Enrollment ID: I20180822003213 |
Provider Name | Bahar Altaha |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1972531630 PECOS PAC ID: 3274598180 Enrollment ID: I20190415002176 |
Provider Name | Constance L Collman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174187546 PECOS PAC ID: 0941536460 Enrollment ID: I20190722002556 |
Provider Name | Brooke A Finley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306217187 PECOS PAC ID: 4880934272 Enrollment ID: I20190723003896 |
Provider Name | Roberta Maixner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487803151 PECOS PAC ID: 5597097204 Enrollment ID: I20191030001434 |
Provider Name | Andrea T Oakes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871132894 PECOS PAC ID: 3971939471 Enrollment ID: I20200131001069 |
Provider Name | Mark Skousen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013529155 PECOS PAC ID: 3375962368 Enrollment ID: I20200924000896 |
Provider Name | Alyson Larson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184231177 PECOS PAC ID: 3476968561 Enrollment ID: I20210223002791 |
Provider Name | Tabatha Grace |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104402338 PECOS PAC ID: 6608284492 Enrollment ID: I20210415001531 |
Provider Name | Jose Angel Rodriguez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942978085 PECOS PAC ID: 3173913795 Enrollment ID: I20211214000251 |
Provider Name | Theresa Marie Mills |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235700881 PECOS PAC ID: 3779974415 Enrollment ID: I20230628004327 |
Provider Name | Tammie Sue Resendez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881380913 PECOS PAC ID: 5294184693 Enrollment ID: I20231211002383 |
Painted Desert Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1310 Smithson Dr, Holbrook, AZ 86025 Phone: 928-503-1827 |