PROFESSIONAL PA-C SERVICES, LLC (NPI# 1396017661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396017661 |
| Entity Type | Organization |
| Organization Name | PROFESSIONAL PA-C SERVICES, LLC |
| Practice Address |
1800 E Florence Blvd Casa Grande AZ 85122-5303 |
| Mailing Address |
24298 S 199th St Queen Creek AZ 85142-3336 |
| Practice Telephone | 8013694800 |
| Practice Fax Number | 4802489011 |
| Mailing Telephone | 8013694800 |
| Mailing Fax Number | 4802489011 |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | KRISTI MARIE PRESTON (MANAGER) |
| Authorized Official Telephone | 8013694800 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
4317 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1800 E FLORENCE BLVD |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85122-5303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023000486 | Anne Borik | Internal Medicine | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2005-08-21 |
| 1952915449 | Maria Kojs | Nurse Practitioner | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2020-09-02 |
| 1265065288 | Aesk LLC | Internal Medicine | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2020-02-18 |
| 1013567361 | Rustom Araia | Pharmacist | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2019-09-18 |
| 1164919056 | East Valley Infectious Diseases LLC | Internal Medicine | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2018-04-17 |
| 1609222827 | Cassandra Koontz | Nurse Practitioner | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2016-05-06 |
| 1144694266 | Earl Asante | Pharmacist | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2015-12-01 |
| 1922475698 | Soniyasri Koochana | Internal Medicine | 1800 E Florence Blvd, Attn: Hospitalist Team, Casa Grande, AZ 85122-5303 | 2015-08-28 |
| 1851785968 | Banner Pharmacy Services LLC | Pharmacy | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2015-03-26 |
| 1538553227 | Sheridan Childrens Healthcare Services of Arizona, Inc. | Pediatrics | 1800 E Florence Blvd, Casa Grande, AZ 85122-5303 | 2015-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1063060291 | Martha Bollin | Registered Nurse | 2631 N. Brown Ave., Casa Grande, AZ 85122 | 2019-08-30 |
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1629532692 | Kirk Lee Mackley | Physical Therapist | Vibrant Care, 1355 E Florence Blvd #137, Casa Grande, AZ 85122 | 2019-01-24 |
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1710455860 | Community Intervention Associates, Inc | Clinic/Center | 1667 N. Trekell Rd, Suite 101 & 102, Casa Grande, AZ 85122 | 2018-11-07 |
| 1245728302 | Jenkins Chiropractic LLC | Chiropractor | 1891 N Trekell Rd Ste 2, Casa Grande, AZ 85122 | 2018-04-24 |
| 1497242408 | Kelly Winnett | Naturopath | 1415 N Trekell Rd Ste 102, Casa Grande, AZ 85122 | 2018-04-16 |
| 1851895783 | Michael Brubaker Counseling | Community/Behavioral Health | 1927 N. Trekell Rd, Ste D, Casa Grande, AZ 85122 | 2018-03-23 |
| 1770095317 | Walmart Stores Inc. | Pharmacy | 1741 E. Florence Blvd, Casa Grande, AZ 85122 | 2017-11-03 |
| Find all providers in zip 85122 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609359215 | Jordan Mckenzie Creed | Physician Assistant | 1281 E Cottonwood Ln, Casa Grande, AZ 85122 | 2018-09-10 |
| 1588043475 | Alivia Wieseler | Physician Assistant | 1637 E Monument Plaza Cir Ste 1, Casa Grande, AZ 85122-5639 | 2015-05-25 |
| 1114320959 | Derek B Carpenter | Physician Assistant | 865 N Arizola Rd, Casa Grande, AZ 85122 | 2014-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928374 | Michael James Porter | Physician Assistant | 20003 N 77th Dr, Glendale, AZ 85308-8339 | 2020-09-30 |
| 1073121505 | Alexandra R Koolmees | Physician Assistant | 1141 E Village Circle Dr S, Phoenix, AZ 85022-4818 | 2020-07-21 |
| 1194343897 | Alyssa Kay Poland | Physician Assistant | 10006 W Los Gatos Dr, Peoria, AZ 85383-3343 | 2020-07-08 |
| 1568080620 | Manuel Gerardo Pompa | Physician Assistant | 3848 N 3rd Ave Unit 3071, Phoenix, AZ 85013-3472 | 2020-07-06 |
| 1932748233 | Hayley Klotz | Physician Assistant | 440 N Navajo Dr, Page, AZ 86040-0950 | 2020-01-03 |
| 1285273987 | Jaclyn Marie Schroeder | Physician Assistant | 7649 E Pinnacle Peak Rd Ste 100, Scottsdale, AZ 85255-6296 | 2019-12-27 |
| 1396388062 | Morgan Taylor Beckwith | Physician Assistant | 2128 Senita Dr, Lake Havasu City, AZ 86403-5756 | 2019-10-24 |
| 1023667623 | Halie Furrier | Physician Assistant | 5345 E Gleneagles Dr, Tucson, AZ 85718-1803 | 2019-09-05 |
| 1871155143 | Terry Craven Wood | Physician Assistant | 7645 W Donald Dr, Peoria, AZ 85383-3142 | 2019-07-08 |
| 1720548753 | Alexis D Elliott | Physician Assistant | 2350 Miracle Mile # 600a, Bullhead City, AZ 86442-7505 | 2019-03-25 |
| Find all providers with the same taxonomy | ||||
| City | CASA GRANDE |
| Zip Code | 85122 |
Please comment or provide details below to improve the information on PROFESSIONAL PA-C SERVICES, LLC.
| 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.