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Evernorth Care Providers - Arizona PC

General Practice Physician in Boise, ID · enumerated 2024 · authorized official Grace Blue, Credentialing Sr. Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1295597821

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Registry record

Entity type Organization (Type 2)
Legal business name Evernorth Care Providers - Arizona PC
Practice address 950 W Bannock St Ste 1100, Boise, ID, 83702
Phone (773) 292-4800
Fax (312) 564-4059
Enumeration date Jan 29, 2024
Last updated in NPPES Jan 29, 2024

Taxonomy & classification

208D00000X General Practice Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Grace Blue
Title Credentialing Sr. Manager
Phone (773) 292-4800

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2024-01-29. Verify at npiregistry.cms.hhs.gov.
Where is Evernorth Care Providers - Arizona PC located?
The practice location on file with NPPES is in Boise, ID.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-01-29.