Blu Advocate Primary Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

BLU ADVOCATE PRIMARY CARE LLC

Practice address

13029 W Vista Paseo Dr
Litchfield Park, AZ 85340-5572

Phone

(480) 388-2988

NPI assigned

Jun 11, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Walkennia Elaine Simpson Earl, AG-ANCP-BC

Title

Primary Care NP

Phone

(480) 388-2988

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1386269728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13029 W VISTA PASEO DR",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853405572",
            "telephone_number": "480-388-2988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13029 W VISTA PASEO DR",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853405572",
            "telephone_number": "480-388-2988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLU ADVOCATE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "SIMPSON EARL",
        "authorized_official_first_name": "WALKENNIA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "PRIMARY CARE NP",
        "authorized_official_telephone_number": "480-388-2988",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "AG-ANCP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bluadvocate7@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office",
            "address_1": "13029 W Vista Paseo Dr",
            "city": "Litchfield Park",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853405572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Clinic/Center in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Primary Care Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.