Family Primary Care, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

FAMILY PRIMARY CARE, LLC

Practice address

1720 Mesquite Ave Ste 100
Lake Havasu City, AZ 86403-5602

Phone

(928) 412-8808

Fax

(928) 412-8807

NPI assigned

Jun 26, 2020

Organization subpart

No

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

Authorized official

Name

Shawn Robert O'Haver, NP

Title

Owner

Phone

(928) 208-2430

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1053938860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 MESQUITE AVE STE 100",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035602",
            "telephone_number": "928-412-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 MESQUITE AVE STE 100",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035602",
            "telephone_number": "928-412-8808",
            "fax_number": "928-412-8807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-26",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "O'HAVER",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-208-2430",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Faber, PHARMD
• Celina Fain, HAD
• Susan Falzon
• Family Care Home Health & Hospice
• Family Care Home Health & Hospice
• Cinderella Famutimi, CRNA
• Zachary D. Fandrich, ATC
• Aubrey Fanning, PHARMD
• Kelley Robin Farley, NP
• Carissa Farrington, SLP

• Family Nurse Practitioner in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.