NPIMap

Organization Active NPI

Magellan Health Services of Arizona, Inc.

  • Case Management Agency
  • Phoenix, AZ
National Provider Identifier
1598880205
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
BH2975 Issued in AZ
Legal business name
MAGELLAN HEALTH SERVICES OF ARIZONA, INC.
Practice address
702 W Dunlap Ave
Phoenix, AZ 85021-3529
Phone
(602) 694-4838
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Authorized official

Name
Dr. Chris Adair Carson, MD
Title
Chief Executive Officer
Phone
(602) 797-8333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X BH2975 AZ Primary

Addresses

Primary practice location

702 W Dunlap Ave
Phoenix, AZ 85021-3529

Mailing address

4129 East Van Buren Street
Suite 150
Phoenix, AZ 85008
Phone (800) 564-5465

Other identifiers 1

IdentifierTypeStateIssuer
535544MedicaidAZ

Other names 1

  • Maricopa Clinic Park North Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1598880205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4129 EAST VAN BUREN STREET",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85008",
            "telephone_number": "800-564-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W DUNLAP AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850213529",
            "telephone_number": "602-694-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGELLAN HEALTH SERVICES OF ARIZONA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "ADAIR",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "602-797-8333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AZ",
            "license": "BH2975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "535544",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maricopa Clinic Park North",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 15, 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.

Verify at the official NPI Registry.