Magellan Health Services of Arizona, Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

BH2137 Issued in AZ

Legal business name

MAGELLAN HEALTH SERVICES OF ARIZONA, INC.

Practice address

634 W Wickenburg Way
#D
Wickenburg, AZ 85390-2268

Phone

(928) 684-5131

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Maricopa Clinic Wickenburg Other name

Locations

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1740304054",
    "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": "634 W WICKENBURG WAY",
            "address_2": "#D",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853902268",
            "telephone_number": "928-684-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGELLAN HEALTH SERVICES OF ARIZONA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "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": "BH2137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133544",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maricopa Clinic Wickenburg",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Debra Jayne Loder, R.D.N.
• Lottis & Associates, P.C.
• Karen J. Lottis, PHD, FNP
• Patrick Dean Lynch, M.D.
• Julie A Macias, MA
• Jan Malacara, PA-C
• Amy Christine Manuele, LCSW
• Frank Harrison Mazziotti Sr., DC
• Barbara Davis McArthur, MC
• Bradley J Meek, DO

• Case Management Agency in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• Case Management Agency in Arizona

• 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.