EVOLUTION HEALTHCARE MANAGEMENT LLC (NPI# 1770951980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770951980 |
Entity Type | Organization |
Organization Name | EVOLUTION HEALTHCARE MANAGEMENT LLC |
Other Organization Name | EVOLUTION MANAGEMENT SERVICES COMPANY |
Practice Address |
7615 E Baseline Rd Suite 101 Mesa AZ 85209-8520 |
Mailing Address |
771 S Cornwall Dr Apache Junction AZ 85120-4812 |
Practice Telephone | 4803547878 |
Mailing Telephone | 6022062017 |
Mailing Fax Number | 4809620202 |
Enumeration Date | 2015-09-03 |
Last Update Date | 2020-06-29 |
Authorized Official Name | FAWN MICHELLE BOONSTRA (PRESIDENT, MANAGER) |
Authorized Official Telephone | 4809620101 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
23951 | AZ | Allopathic & Osteopathic Physicians |
N | 261QS1200X |
Clinic/Center Specialization: Sleep Disorder Diagnostic |
AZ | Ambulatory Health Care Facilities | |
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
AZ | Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
EVOLUTION MANAGEMENT SERVICES COMPANY | Former Legal Business Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
4545 N Hunt Hwy, Florence, AZ 851326937 | 4809620101 | 4809620202 |
5880 S Hospital Dr Ste 1, Globe, AZ 855019447 | 4809620101 | 4809620202 |
6820 S Kings Ranch Rd Ste 130, Gold Canyon, AZ 851182959 | 4809620101 | 4809620202 |
7115 E Baseline Rd Ste 110, Mesa, AZ 852094039 | 4809620101 | 4809620202 |
99 S Gold Dr, Ste. 6, Apache Junction, AZ 851205035 | 6206943190 | 4809620202 |
Street Address |
7615 E BASELINE RD SUITE 101 |
City | MESA |
State | AZ |
Zip Code | 85209-8520 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801444013 | Phylogenesis Financial Holdings LLC | Clinic/Center | 7615 E Baseline Rd, Mesa, AZ 85209 | 2019-08-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013539568 | Wingfoot Wellness & Hormones LLC | Nurse Practitioner | 2500 S Power Road, Building 7 Suite 218, Mesa, AZ 85209 | 2020-05-07 |
1558916247 | Shiny Susan Thomas | Family Medicine | 7615,east Baseline Road, Mesa, AZ 85209 | 2019-08-08 |
1245798933 | Premier Care Medical Services Pllc | Clinic/Center | 7363 E Naranja Ave, Mesa, AZ 85209 | 2019-03-12 |
1518450568 | Mhb Services | Internal Medicine | 1301 S Crismon Road, Mesa, AZ 85209 | 2018-06-13 |
1174012934 | Andrew Swenson | Student in an Organized Health Care Education/Training Program | 10238 E. Hampton #406, Mesa, AZ 85209 | 2018-05-08 |
1689196057 | Monica R Meyer | Registered Nurse | 2424 S Rowen, Mesa, AZ 85209 | 2017-07-07 |
1629507041 | Rachel Ann Navarro | Occupational Therapist | 10431 E Natal Ave, Mesa, AZ 85209 | 2017-06-08 |
1073041331 | Michelle Resendez | Nurse Practitioner | 2500 S Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-31 |
1275069569 | Michelle Amado | Nurse Practitioner | 2500 S. Power Rd, Bldg 7, Ste 218, Mesa, AZ 85209 | 2017-05-04 |
1982138079 | Warren Brent Thomas | Nurse Anesthetist, Certified Registered | 10632 E Kiva Ave, Mesa, AZ 85209 | 2017-04-14 |
Find all providers in zip 85209 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114541752 | Allied Medical Associates Plc | Clinic/Center | 7525 E Broadway Rd Ste 9, Mesa, AZ 85208-1156 | 2020-05-29 |
1245798933 | Premier Care Medical Services Pllc | Clinic/Center | 7363 E Naranja Ave, Mesa, AZ 85209 | 2019-03-12 |
1538653787 | Vijay S Gill Md PC | Clinic/Center | 2152 S Vineyard Ste 119, Mesa, AZ 85210-6881 | 2018-06-20 |
1881944619 | Concentra Primary Care of Arizona, Pa | Clinic/Center | 1345 E. Mckellips Road, Suite 106, Mesa, AZ 85203 | 2012-09-19 |
1073803508 | Mikel W Skousen Do Ltd | Clinic/Center | 457 E 4th Pl, Mesa, AZ 85203-7154 | 2011-04-18 |
1740596733 | Arizona Family & Geriatric Medicine Pllc | Clinic/Center | 5602 E. Main St., Mesa, AZ 85205 | 2010-08-27 |
1013035211 | Judy M Pinsonneault, D.o., P.C. | Clinic/Center | 6106 E Brown Rd Ste 102, Mesa, AZ 85205-4954 | 2007-03-26 |
1578181822 | Seitz Medical Pllc | Clinic/Center | 2424 E Ivy St, Mesa, AZ 85213-3513 | 2020-07-13 |
1922567817 | A New Leaf, Inc. | Clinic/Center | 2254 W Main St, Mesa, AZ 85201-6847 | 2019-03-19 |
1124518204 | Community Bridges, Inc. | Clinic/Center | 460 N Mesa Dr, Mesa, AZ 85201-5973 | 2018-05-15 |
Find all providers in MESA |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.