Eminence Medical Clinic PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

EMINENCE MEDICAL CLINIC PLLC

Practice address

2815 S Alma School Rd Ste 112
Mesa, AZ 85210-4046

Phone

(480) 221-2227

NPI assigned

Jan 30, 2023

Last updated

May 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leah EchiverriNPI 1265663736

Title

Ceo

Phone

(480) 221-2227

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leah Jhoana Echiverri, NP

  • Adult Health Nurse Practitioner
  • Mesa, AZ
  • NPI 1265663736

  Family

  Medicare reassignment Care Compare group NPD Authorized official
• Alyssa Allen, RN

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1053896902
  Medicare reassignment Care Compare group NPD
• Terrianne Kay Doner, FNP-C

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1659190049
  Medicare reassignment Care Compare group NPD
• Tiffany Marie Fry, FNP

  • Primary Care Nurse Practitioner
  • Gilbert, AZ
  • NPI 1316787583
  Medicare reassignment NPD
• Kimberly Dawn Lee, APRN

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1104502590
  NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716595200000",
    "number": "1316653579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 S ALMA SCHOOL RD STE 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104046",
            "telephone_number": "602-402-5059",
            "fax_number": "623-321-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S ALMA SCHOOL RD STE 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852104046",
            "telephone_number": "480-221-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMINENCE MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2024-05-25",
        "certification_date": "2024-05-25",
        "status": "A",
        "authorized_official_last_name": "ECHIVERRI",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-221-2227"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Mesa, AZ
• Providers in Mesa, 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 May 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.