Organization Active NPI

Prime Virtual Care Center LLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1013843861
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PRIME VIRTUAL CARE CENTER LLC
Practice address
4539 N 22ND St Ste R
Phoenix, AZ 85016-4639
Phone
(520) 843-4567
NPI assigned
Jun 19, 2026
Organization subpart
Yes
Parent organization
PRIME VIRTUAL CARE CENTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Smith Jackson
Title
Manager
Phone
(520) 843-4567

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4539 N 22ND St Ste R
Phoenix, AZ 85016-4639

Mailing address

165 Ithaca St
Bay Shore, NY 11706-4606
Phone (520) 843-4567

National Provider Directory

National Provider Directory
Tax ID family
Prime Virtual Care Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1781827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1013843861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 ITHACA ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117064606",
            "telephone_number": "520-843-4567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4539 N 22ND ST STE R",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164639",
            "telephone_number": "520-843-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME VIRTUAL CARE CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME VIRTUAL CARE CENTER LLC",
        "enumeration_date": "2026-06-19",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SMITH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "520-843-4567"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.