Active NPI
Edward Griffin Cipolla, DO
- Family Medicine Physician
- Phoenix, AZ
National Provider Identifier
1144374281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2811
- Practice address
- 120 E Monterey Way
Phoenix, AZ 85012-2618 - Phone
- (602) 266-4383
- Fax
- (602) 266-4384
- NPI assigned
- Jan 23, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2811 | AZ | Primary |
Addresses
Primary practice location
120 E Monterey Way
Phoenix, AZ 85012-2618
Mailing address
120 E Monterey Way
Phoenix, AZ 85012-2618
Phone (602) 266-4383
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 341769 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144374281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 E MONTEREY WAY",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122618",
"telephone_number": "602-266-4383",
"fax_number": "602-266-4384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E MONTEREY WAY",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122618",
"telephone_number": "602-266-4383",
"fax_number": "602-266-4384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIPOLLA",
"first_name": "EDWARD",
"middle_name": "GRIFFIN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "2811",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "341769",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.