Prestige Primary Care, PLLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

PRESTIGE PRIMARY CARE, PLLC

Practice address

21321 E Ocotillo Rd Ste 102
Queen Creek, AZ 85142-5993

Phone

(480) 815-7074

NPI assigned

Oct 25, 2018

Organization subpart

No

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

Authorized official

Name

Candee J EisenhartNPI 1891233714

Title

Owner

Phone

(480) 815-7074

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Candee J. Eisenhart, NP

  • Family Nurse Practitioner
  • Queen Creek, AZ
  • NPI 1891233714
  NPD Authorized official

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1144797374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1009",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421821",
            "telephone_number": "480-815-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21321 E OCOTILLO RD STE 102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425993",
            "telephone_number": "480-815-7074"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6343 E Main St Ste B1",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852058972",
            "country_code": "US",
            "telephone_number": "480-815-7074",
            "fax_number": "949-404-6076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1963 Commerce Center Cir Ste B",
            "address_purpose": "LOCATION",
            "city": "Prescott",
            "state": "AZ",
            "postal_code": "863014497",
            "country_code": "US",
            "telephone_number": "480-815-7074",
            "fax_number": "949-404-6076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRESTIGE PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "EISENHART",
        "authorized_official_first_name": "CANDEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-815-7074"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dwan Price-Katz, CPM
• Primary Care Practice of Arizona, PLLC (Gateway Urgent Care)
• Prism Community Care LLC
• Private Healthcare Facilities

• Primary Care Nurse Practitioner in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.