NPIMap

Organization Active NPI

Novastack LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1215855465
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
NOVASTACK LLC
Practice address
4539 N 22ND St Ste R
Phoenix, AZ 85016-4639
Phone
(480) 210-2734
NPI assigned
Jul 7, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Virginia Bentley
Title
Owner
Phone
(480) 210-2734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

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

Mailing address

4539 N 22ND St Ste R
Phoenix, AZ 85016-4639
Phone (480) 210-2734

National Provider Directory

National Provider Directory
Tax ID family
Novastack LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1783382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1215855465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4539 N 22ND ST STE R",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164639",
            "telephone_number": "480-210-2734"
        },
        {
            "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": "480-210-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVASTACK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-07",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-210-2734"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "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 7, 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.