Black Canyon Community Health Center Inc.
NPI 1124730627 · Federally Qualified Health Center (FQHC) · Mayer, AZ
Enrolled with Medicare as Part a Provider - Federally Qualified Health Center (fqhc) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Black Canyon Community Health Center Inc. is a Federally Qualified Health Center (FQHC) organization in Mayer, AZ (NPI 1124730627).
Provider details
- NPI number
- 1124730627
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Randy Hancock, Ceo(623) 374-0200
Specialties & taxonomies
Ambulatory Health Care Facilities
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-12-16
- Last updated
- 2022-12-16
- Certified
- 2022-12-16
Frequently asked questions
- What is Black Canyon Community Health Center Inc.'s NPI number?
- Black Canyon Community Health Center Inc.'s National Provider Identifier (NPI) is 1124730627, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Black Canyon Community Health Center Inc.?
- Black Canyon Community Health Center Inc. is classified in the NPPES registry as Federally Qualified Health Center (FQHC) (Ambulatory Health Care Facilities).
- Where is Black Canyon Community Health Center Inc. located?
- Black Canyon Community Health Center Inc.'s practice location on file with NPPES is 17301 E Spring Valley Rd Ste F, Mayer, AZ 86333-4263.
- What is Black Canyon Community Health Center Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Black Canyon Community Health Center Inc. is (623) 374-0200.
- Does Black Canyon Community Health Center Inc. accept Medicare?
- Black Canyon Community Health Center Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Black Canyon Community Health Center Inc.?
- The authorized official listed on Black Canyon Community Health Center Inc.'s NPPES record is Randy Hancock, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Black Canyon Community Health Center Inc.'s NPI active?
- Yes — Black Canyon Community Health Center Inc.'s NPI (1124730627) is active in the NPPES registry as of the last update on 2022-12-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.