EVOLUTION HEALTHCARE MANAGEMENT LLC – NPI #1770951980
Clinic/Center

EVOLUTION HEALTHCARE MANAGEMENT LLC is an AHC clinic located in MESA, AZ. NPPES has assigned the NPI number 1770951980 to EVOLUTION HEALTHCARE MANAGEMENT LLC on September 03, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

The NPI profile was last updated on Sep 12, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EVOLUTION HEALTHCARE MANAGEMENT LLC below.

NPI Profile for
EVOLUTION HEALTHCARE MANAGEMENT LLC

NPI Number
1770951980
Enumeration Date

(about 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EVOLUTION HEALTHCARE MANAGEMENT LLC
Primary location
7615 E BASELINE RD
SUITE 101
MESA, AZ 85209-8520
Phone: (480) 354-7878 Fax:
1 Other location(s):
99 S Gold Dr
Ste. 6
Apache Junction, AZ 85120-5035
Phone: (620) 694-3190
Fax: (480) 962-0202
Mailing address
99 S GOLD DR STE 6
APACHE JUNCTION, AZ 85120-5036
Phone: (480) 354-7878 Fax: (949) 577-4159
Organization Subpart
No
Authorized Official
FAWN BOONSTRA
PRESIDENT, MANAGER
Phone: (480) 286-7907
Updated
Certification Date
Apr 12, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)		 AZ

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
,
, 77025-1669