NPIMap

Organization Active NPI

Cigna Health Care of Arizona Inc.

Doing business as EVERNORTH Care Group South Mountain Health Center

  • Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1508937236
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
OTC 0648 Issued in AZ
Legal business name
CIGNA HEALTH CARE OF ARIZONA INC.
Doing business as
EVERNORTH Care Group South Mountain Health Center
Practice address
7236 S Central Ave
Phoenix, AZ 85042-5425
Phone
(602) 276-5565
NPI assigned
Nov 13, 2006
Last updated
Jun 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Authorized official

Name
Kevin Ellis, D.O.
Title
Chief Medical Director
Phone
(623) 277-2246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X OTC 0648 AZ Primary

Addresses

Primary practice location

7236 S Central Ave
Phoenix, AZ 85042-5425

Mailing address

8888 E Raintree Dr FL 3
Scottsdale, AZ 85260-3951
Phone (602) 328-8400

Other identifiers 1

IdentifierTypeStateIssuer
061812MedicaidAZ

Other names 1

  • EVERNORTH Care Group South Mountain Health Center Doing business as

National Provider Directory

National Provider Directory

Locations

8888 E Raintree Dr
Ste 300
Scottsdale, AZ 85260
Phone (602) 328-8400

Practitioners & affiliated clinicians

Practitioners 11

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686873600000",
    "number": "1508937236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8888 E RAINTREE DR FL 3",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603951",
            "telephone_number": "602-328-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7236 S CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425425",
            "telephone_number": "602-276-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIGNA HEALTH CARE OF ARIZONA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CHIEF MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "623-277-2246",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "AZ",
            "license": "OTC 0648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "061812",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVERNORTH Care Group South Mountain Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 16, 2023; 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.