PREVENCARE HEALTH SERVICES, LLC (NPI# 1447864830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447864830 |
| Entity Type | Organization |
| Organization Name | PREVENCARE HEALTH SERVICES, LLC |
| Practice Address |
750 Bartow Dr Ste 16 Sierra Vista AZ 85635-1833 |
| Mailing Address |
1422 S Apache Dr Chandler AZ 85286-6300 |
| Practice Telephone | 8584493798 |
| Mailing Telephone | 8584493798 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Authorized Official Name | ERICK LEE (OWNER) |
| Authorized Official Telephone | 8584493798 |
| Authorized Official Credential | ERICK LEE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 441076 | 05 |
| Other Name | Type Code |
|---|---|
| PrevenCare Health Services, LLC | Doing Business As Name - Organization |
| PrevenCare Health Services, LLC | Former Legal Business Name - Organization |
| Street Address |
750 BARTOW DR STE 16 |
| City | SIERRA VISTA |
| State | AZ |
| Zip Code | 85635-1833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134740640 | Taylor Anne Phelps | Student in an Organized Health Care Education/Training Program | Haven of Sierra Vista LLC, 660 Coronado Drive, Sierra Vista, AZ 85635 | 2020-05-06 |
| 1568001543 | Gp Medicine, Pllc | Family Medicine | 1800 E Wilcox Drive, Sierra Vista, AZ 85635 | 2019-12-23 |
| 1518515212 | Canyon Vista Dental | Dentist | 1993 S Frontage Road, Suite 208, Sierra Vista, AZ 85635 | 2019-08-27 |
| 1225697402 | Kristine Vincent Cruz Angeles | Dentist | 115 Calle Poral, Sierra Vista, AZ 85635 | 2019-06-11 |
| 1700397411 | Vivian Ryu | Social Worker | 2300 E Fry Blvd, #3822, Sierra Vista, AZ 85635 | 2017-10-20 |
| 1750806758 | Rosemary Nduta Kagwanja | Technician | 425 Bernini Avenue, N/a, Sierra Vista, AZ 85635 | 2017-08-10 |
| 1093245789 | Akdhc, LLC | Internal Medicine | 5555 Mesa Verde Dr, Suite 100, Sierra Vista, AZ 85635 | 2017-06-14 |
| 1609304633 | Vincent Guarino | Emergency Medicine | 5700 E, Az-90, Sierra Vista, AZ 85635 | 2017-06-04 |
| 1629506811 | Andrew Tang | Student in an Organized Health Care Education/Training Program | 5700 Arizona 90, Sierra Vista, AZ 85635 | 2017-06-01 |
| 1194259382 | Walik Hargett | Contractor | 800 N. Lenzner Ave Apt 776b, Sierra Vista, AZ 85635 | 2017-04-14 |
| Find all providers in zip 85635 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942811997 | Raquiel Santos | Family Medicine | 4301 Plaza Vis Apt C, Sierra Vista, AZ 85635-4323 | 2020-08-13 |
| 1568001543 | Gp Medicine, Pllc | Family Medicine | 1800 E Wilcox Drive, Sierra Vista, AZ 85635 | 2019-12-23 |
| 1821541723 | Joseph Thompson | Family Medicine | 5700 Az 90, Sierra Vista, AZ 85635 | 2016-07-27 |
| 1821238171 | Ann Lebeck | Family Medicine | 3353 Canyon De Flores, Suite A, Sierra Vista, AZ 85650 | 2009-02-26 |
| 1073703310 | Jeffrey Virgil Wilde | Family Medicine | 2585 E Wilcox Dr Ste A, Sierra Vista, AZ 85635-2822 | 2007-08-01 |
| 1710025051 | Papago Medical, PC | Family Medicine | 1729 Paseo San Luis, Sierra Vista, AZ 85635-4611 | 2007-02-01 |
| 1356356067 | Louise Nosanchuck | Family Medicine | 77 E Fry Blvd, Sierra Vista, AZ 85635-1813 | 2006-07-30 |
| 1699796631 | Marc A Kaplan Pllc | Family Medicine | 2585 E Wilcox Dr Ste C, Sierra Vista, AZ 85635-2822 | 2006-07-23 |
| 1619918836 | Marc A Kaplan | Family Medicine | 2585 E Wilcox Dr., #c, Sierra Vista, AZ 85635 | 2006-06-09 |
| 1881663615 | Archana Bansal | Family Medicine | 157 N Coronado Dr, #c, Sierra Vista, AZ 85635-6360 | 2006-03-15 |
| Find all providers in SIERRA VISTA | ||||
| City | SIERRA VISTA |
| Zip Code | 85635 |
Please comment or provide details below to improve the information on PREVENCARE HEALTH 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.