Phoenix CM Incorporated

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Legal business name

PHOENIX CM INCORPORATED

Practice address

52 Tuscan Way
Ste. 202-142
Saint Augustine, FL 32092-1850

Phone

(904) 201-9275

NPI assigned

Apr 16, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Ella B. Russell

Title

Executive Director

Phone

(443) 880-6124

Specialties & licenses 1

Addresses

Tax ID family

Phoenix CM Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Phoenix CM Inc.

  • Case Management Agency
  • Jacksonville, FL
  • NPI 1740687664
  NPD tax ID

Locations

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334534400000",
    "number": "1306103353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 TUSCAN WAY",
            "address_2": "STE. 202-142",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320921850",
            "telephone_number": "904-201-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 TUSCAN WAY",
            "address_2": "STE. 202-142",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320921850",
            "telephone_number": "904-201-9275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX CM INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ELLA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-880-6124",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashton Phillips, APRN
• Christina Marie Tipple Phillips, OT
• Jhaleil Phillips, OD
• Morgan Phillips
• Story Phillips, MS CCC-SLP
• Phoenix Rises Acupuncture
• Physical Intelligence LLC
• Physical Intelligence St. Augustine
• Physical Therapy on Demand LLC
• Physician Associates Group, Inc.

• Case Manager/Care Coordinator in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.