Promedisch, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP4802 Issued in AZ

Legal business name

PROMEDISCH, LLC

Practice address

2525 W Carefree Hwy Ste 118
Phoenix, AZ 85085-9302

Phone

(623) 748-9106

Fax

(602) 429-8579

NPI assigned

Apr 2, 2017

Organization subpart

No

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

Authorized official

Name

Laura MagoffieNPI 1376880997

Title

NP

Phone

(623) 748-9106

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laura Mae Magoffie, RN, FNP

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1376880997
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1491091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1144752759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39506 N DAISY MOUNTAIN DR",
            "address_2": "SUITE 122-169",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850861663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W CAREFREE HWY STE 118",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850859302",
            "telephone_number": "623-748-9106",
            "fax_number": "602-429-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMEDISCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-02",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "MAGOFFIE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "623-748-9106"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP4802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Project222 LLC
• Lizbeth Prokop
• Olga Prokopets, DDS
• Prolete Health PLLC
• Manassawee Promchoot
• Prompt Foot and Ankle PLLC
• Brittany Pronty, OTR/L
• Prop Anesthesia LLC
• Propel Treatment Center LLC
• Keneth Prophete

• Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.