VIRGINIA PRENDERGAST (NPI# 1578633657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578633657 |
| Entity Type | Individual |
| Full Name | VIRGINIA PRENDERGAST |
| Credential | NP |
| Practice Address |
1424 E Marshall Ave Phoenix AZ 85014-2358 |
| Practice Telephone | 4802204688 |
| Practice Fax Number | 6024064969 |
| Mailing Telephone | 4802204688 |
| Mailing Fax Number | 6024064969 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2015-11-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN039088 | AZ | Nursing Service Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AP6877 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1424 E MARSHALL AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85014-2358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295111987 | Virginia Prendergast LLC | Nurse Practitioner | 1424 E Marshall Ave, Phoenix, AZ 85014-2358 | 2015-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796549 | Sherri Ann Rhodes | Registered Nurse | 5727 North 7th Street, Suite 308, Phoenix, AZ 85014 | 2020-10-06 |
| 1235746249 | Kaitlyn Landess | Occupational Therapist | 1190 W. Missouri Ave, Suite 100, Phoenix, AZ 85014 | 2020-09-24 |
| 1467088062 | Generational Bridges Neuropsychological Services Pllc | Clinical Neuropsychologist | 1515 E Missouri Dr, Phoenix, AZ 85014 | 2020-03-16 |
| 1861022881 | Daza Astrid Hernandez | Speech-Language Pathologist | 5314 N 7th Street, Phoeniz, AZ 85014 | 2020-01-17 |
| 1396213542 | Arizona Youth & Family Services Inc. | Community/Behavioral Health | 3707 N. 7th Street, Ste. 200, Phoenix, AZ 85014 | 2018-11-06 |
| 1366815508 | Dehp LLC | Case Management | 3707 N. 7th St., Ste # 310, Phoenix, AZ 85014 | 2015-11-10 |
| 1659751972 | Carla Parola | Counselor | 1300 E Missouri Ave Ste A-120, Phoenix, AZ 85014 | 2015-06-02 |
| 1659763597 | Dale Carroll Davis | Dentist | 3132 N. 7th St, Phoenix, AZ 85014 | 2015-03-02 |
| 1407247091 | Cynthia Ruzich | Psychologist | 1450 E. Indian School Rd. #101, Phoenix, AZ 85014 | 2015-02-18 |
| 1144618315 | Emily M Bentz | Specialist/Technologist | 3514 N. 7th St, Phoenix, AZ 85014 | 2014-12-22 |
| Find all providers in zip 85014 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819230 | Care On Pllc | Nurse Practitioner | 7171 S 51 Ave, Phoenix, AZ 85339-2923 | 2020-07-23 |
| 1558985036 | Amanda Stanford | Nurse Practitioner | 925 E Mc Dowell Rd, Phoenix, AZ 85006 | 2020-06-01 |
| 1710522024 | Kelsey Conrad | Nurse Practitioner | 1 E Lexington Ave Unit 1602, Phoenix, AZ 85012-4203 | 2019-11-11 |
| 1124662408 | Rayiom Health and Wellness, Inc | Nurse Practitioner | 11225 N 28th Dr Ste A102-22, Phoenix, AZ 85029-5606 | 2019-10-30 |
| 1699259580 | Keith Dibenedetto | Nurse Practitioner | 2617 Stockton Rd, Phoenix, MD 21131-1117 | 2018-09-18 |
| 1467975698 | Samantha June Collett | Nurse Practitioner | 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 | 2017-07-19 |
| 1598135741 | Sandra Shearer | Nurse Practitioner | 513 W Lavitt Ln, Phoenix, AZ 85086-6346 | 2015-09-30 |
| 1023499860 | Kelly Lynn Schultz | Nurse Practitioner | 3944 E Hillery Dr, Phoenix, AZ 85032-5245 | 2015-06-17 |
| 1609298900 | Lorna Ann Hill | Nurse Practitioner | 13224 N 31st Pl, Phoenix, AZ 85032-6041 | 2014-01-06 |
| 1801217765 | Trifit Pain Management LLC | Nurse Practitioner | 505 E Camelback Rd, Phoenix, AZ 85012-1615 | 2013-12-19 |
| Find all providers in PHOENIX | ||||
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| 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.