Camelback Mountain Medical Associates PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2811 Issued in AZ

Legal business name

CAMELBACK MOUNTAIN MEDICAL ASSOCIATES PC

Practice address

120 E Monterey Way
Phoenix, AZ 85012-2618

Phone

(602) 266-4383

Fax

(602) 266-4384

NPI assigned

Nov 2, 2012

Last updated

Nov 2, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edward Griffin Cipolla, DONPI 1144374281

Title

Owner/President

Phone

(602) 266-4383

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charlene Frances Baldwin, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1033546411
  Medicare reassignment NPD
• Lucy Pitts, FNP-BC

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1215368964
  Medicare reassignment NPD
• Janna T Roberts, F.N.P

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1033536362
  Medicare reassignment NPD
• Edward Griffin Cipolla, DO

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1144374281
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351814400000",
    "number": "1164776845",
    "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": {
        "organization_name": "CAMELBACK MOUNTAIN MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-02",
        "last_updated": "2012-11-02",
        "status": "A",
        "authorized_official_last_name": "CIPOLLA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "GRIFFIN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "602-266-4383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "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": []
}

• Camelback Dermatology & Skin Surgery, Inc
• Camelback Hospice LLC
• Camelback Imaging Holdings LLC
• Camelback Medical Care LLC
• Camelback Medical Centers PLLC
• Camelback Pediatric Dentistry and Orthodontics
• Camelback Pediatrics PC
• Camelback Physical Therapy, LLC
• Camelback Physicians Group LLC
• Camelback Physicians Group LLC

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.