NPIMap

Organization Active NPI

McKellips Internal Medicine PLLC

  • Internal Medicine Physician
  • Mesa, AZ
National Provider Identifier
1477095735
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
37616 Issued in AZ
Legal business name
MCKELLIPS INTERNAL MEDICINE PLLC
Practice address
3049 E McKellips Rd Ste 5
Mesa, AZ 85213-3144
Phone
(480) 830-1553
Fax
(480) 981-2442
NPI assigned
Nov 17, 2016
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Dr. Charles B Evans II, MDNPI 1275754517
Title
Medical Director
Phone
(602) 791-9112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 37616 AZ Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

3049 E McKellips Rd Ste 5
Mesa, AZ 85213-3144

Mailing address

13840 N Northsight Blvd Ste 121
Scottsdale, AZ 85260-3665
Phone (480) 588-6924

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1479340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1477095735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13840 N NORTHSIGHT BLVD STE 121",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603665",
            "telephone_number": "480-588-6924",
            "fax_number": "480-634-5819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3049 E MCKELLIPS RD STE 5",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852133144",
            "telephone_number": "480-830-1553",
            "fax_number": "480-981-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCKELLIPS INTERNAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-17",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "602-791-9112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "37616",
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.