Evernorth Care Providers - Arizona PC
NPI 1417712233ActiveOrganization· General Practice· Albuquerque, NM
General Practice in Albuquerque, New Mexico, registered in NPPES in February 2024. The authorized official on file is Grace Blue, Credentialing Sr. Manager.
Overview
| NPI | 1417712233 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 20, 2024 |
| Last updated in NPPES | Feb 20, 2024 |
| Certified by provider | Feb 20, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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