{
  "npi": "1265719918",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "ALYSIA",
    "authorized_official_last_name": "CARDONA",
    "authorized_official_telephone_number": "7605724100",
    "authorized_official_title_or_position": "Chief Executive Officer",
    "certification_date": "2026-10-07",
    "enumeration_date": "2011-11-09",
    "last_updated": "2026-10-07",
    "organization_name": "DHHS PHS IHS PHOENIX AREA",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "401 PICACHO ROAD",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WINTERHAVEN",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "760-572-2133",
      "postal_code": "92283",
      "state": "CA",
      "telephone_number": "760-572-4100"
    },
    {
      "address_1": "401 PICACHO RD",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "WINTERHAVEN",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "760-572-4183",
      "postal_code": "922839605",
      "state": "CA",
      "telephone_number": "760-572-4100"
    }
  ],
  "taxonomies": [
    {
      "code": "261Q00000X",
      "desc": "Clinic/Center",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "70",
        "medicare_type": "Clinic or Group Practice"
      }
    ]
  }
}