| Intermountain Health Center Inc | |
|
5055 E Broadway Blvd Ste C104 Tucson AZ 85711-3641 | |
| (520) 628-9833 | |
| (520) 623-9083 |
| Full Name | Intermountain Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5055 E Broadway Blvd Ste C104, Tucson, Arizona |
| Authorized Official Name and Position | Rose Mary Lopez (PRESIDENT AND CEO) |
| Authorized Official Contact | 5207211887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermountain Health Center Inc Po Box 86537 Tucson AZ 85754-6537 Ph: (520) 721-1887 | Intermountain Health Center Inc 5055 E Broadway Blvd Ste C104 Tucson AZ 85711-3641 Ph: (520) 628-9833 |
| NPI Number | 1609245273 |
|---|---|
| Provider Enumeration Date | 09/24/2015 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 7113253659 |
|---|---|
| Medicare Enrollment ID | O20190722003187 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609245273 | NPI | - | NPPES |
| OTC7779 | Other | AZ | ADHS/BMFL LICENSE |
| 198509 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Stephen Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760432009 PECOS PAC ID: 8325943566 Enrollment ID: I20031202000076 |
| Provider Name | Justine R Confino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881781847 PECOS PAC ID: 2062485675 Enrollment ID: I20040812001330 |
| Provider Name | Melanie Villa Romo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134216104 PECOS PAC ID: 7012012537 Enrollment ID: I20070411000475 |
| Provider Name | Sylvia P Valenzuela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578822680 PECOS PAC ID: 6901052166 Enrollment ID: I20120803000764 |
| Provider Name | Phillip Plemons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871840199 PECOS PAC ID: 8921321043 Enrollment ID: I20160608000339 |
| Provider Name | Ian Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417402280 PECOS PAC ID: 8820374911 Enrollment ID: I20170403002154 |
| Provider Name | Erkan Caygoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356868160 PECOS PAC ID: 0547528218 Enrollment ID: I20171229002261 |
| Provider Name | Margarita N Elias |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134618242 PECOS PAC ID: 2961758511 Enrollment ID: I20180711003967 |
| Provider Name | Charles Christian Kohnken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306399027 PECOS PAC ID: 2961799192 Enrollment ID: I20180903000080 |
| Provider Name | Kaacha Star Naminda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679161889 PECOS PAC ID: 0749696045 Enrollment ID: I20210525001596 |
| Provider Name | Mosunmola Ogunyinmi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205495165 PECOS PAC ID: 3375945454 Enrollment ID: I20210712003661 |
| Provider Name | Christine M Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659443810 PECOS PAC ID: 5890030712 Enrollment ID: I20210810001952 |
| Provider Name | William H Ruby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003149691 PECOS PAC ID: 5597806893 Enrollment ID: I20211029001373 |
| Provider Name | Hayley F Garigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235807983 PECOS PAC ID: 5193199610 Enrollment ID: I20230324001366 |
| Provider Name | Kathy Ann Jacobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982361127 PECOS PAC ID: 1153795596 Enrollment ID: I20230324002664 |
| Provider Name | Seena Sunny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164283818 PECOS PAC ID: 7113362534 Enrollment ID: I20240226001203 |
| Provider Name | Joy-anne Simone James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205381498 PECOS PAC ID: 2567742380 Enrollment ID: I20240229003657 |
| Provider Name | Martin Romeo Tamou |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114785953 PECOS PAC ID: 1456791748 Enrollment ID: I20240503001093 |
| Provider Name | Jovan Martiza Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144796152 PECOS PAC ID: 0446691489 Enrollment ID: I20240508003141 |
| Provider Name | Jonathon D Furlong |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356637870 PECOS PAC ID: 7012450778 Enrollment ID: I20240621003307 |
| Provider Name | Yovana Apodaca |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235736208 PECOS PAC ID: 8123561883 Enrollment ID: I20240621003560 |
| Provider Name | Lisa M Lenius |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386130318 PECOS PAC ID: 8123561768 Enrollment ID: I20240624001958 |
| Provider Name | Peter Francis Tolhurst |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225554363 PECOS PAC ID: 6709321185 Enrollment ID: I20240710000255 |
| Provider Name | Arlene L Woolfolk Soto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457196826 PECOS PAC ID: 1355887811 Enrollment ID: I20240722001270 |
Nancy E Campbell, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2230 E. Speedway Blvd., Suite 100, Tucson, AZ 85719 Phone: 520-878-7857 Fax: 520-572-2049 | |
Counterpoint Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1661 N Swan Rd Ste 200-2, Tucson, AZ 85712 Phone: 520-990-3122 | |
Psyche Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5240 E Knight Dr Ste 120, Tucson, AZ 85712 Phone: 520-795-0309 Fax: 520-795-2030 | |
Counseling Directions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 N Alvernon Way Ste 105, Tucson, AZ 85711 Phone: 520-561-8773 | |
B. Robert Crago Phd Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 5363 E Pima St Ste 100, Tucson, AZ 85712 Phone: 520-323-0062 Fax: 520-323-1336 | |