Colorado River Primary Care, Inc
NPI 1669146536ActiveOrganization· Internal Medicine· Fort Mohave, AZ
Internal Medicine in Fort Mohave, Arizona, registered in NPPES in August 2021. The authorized official on file is Wantzy Cooper, DO, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1669146536 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 4, 2021 |
| Last updated in NPPES | Mar 4, 2024 |
| Certified by provider | Mar 4, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Clinic/Center, Primary Care | 261QP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AZ) |
|---|
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