Phoenix CM Inc.

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

PHOENIX CM INC.

Practice address

1225 W Beaver St Ste 101
Jacksonville, FL 32204-1415

Phone

(904) 377-6735

NPI assigned

Nov 20, 2014

Organization subpart

No

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

Authorized official

Name

Ella B Russell

Title

Executive Director

Phone

(904) 377-6735

Specialties & licenses 1

Addresses

Other identifiers 1

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 Incorporated

  • Case Manager/Care Coordinator
  • Saint Augustine, FL
  • NPI 1306103353
  NPD tax ID

Locations

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1740687664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 TUSCAN WAY STE 202-142",
            "address_2": "STE. 202-142",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320921850",
            "telephone_number": "904-377-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W BEAVER ST STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041415",
            "telephone_number": "904-377-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX CM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "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": "904-377-6735"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006238200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Takayla Phillips
• William Phillips
• Cherika Philo
• Philosophie Therapy LLC
• Phoenix Behavioral Health Services, Inc.
• Phoenix Healthcare Properties of Mandarin, LLC
• Phoenix Rising Solutions Inc
• Phoenix Rising Wellness & Counseling
• Phoenix Therapeutic Services, Inc
• Ava E Phoenix, M.D.

• Case Management Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Case Management Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.