NPIMap

Organization Active NPI

Magellan Health Services of Arizona, Inc.

  • Case Management Agency
  • Phoenix, AZ
National Provider Identifier
1821112129
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
BH2966 Issued in AZ
Legal business name
MAGELLAN HEALTH SERVICES OF ARIZONA, INC.
Practice address
4707 N 12TH St
Phoenix, AZ 85014-4009
Phone
(602) 241-4600
NPI assigned
Mar 19, 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 BH2966 AZ Primary

Addresses

Primary practice location

4707 N 12TH St
Phoenix, AZ 85014-4009

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
981458MedicaidAZ

Other names 1

  • Maricopa Clinic Highland Other name

National Provider Directory

National Provider Directory
Tax ID family
Vo of Arizona Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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": "1821112129",
    "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": "4707 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850144009",
            "telephone_number": "602-241-4600"
        }
    ],
    "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": "BH2966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "981458",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maricopa Clinic Highland",
            "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.