Organization Active NPI

LHCG Clxxii, LLC

Doing business as Casa de la Luz Palliative Care

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1407458532
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LHCG CLXXII, LLC
Doing business as
Casa de la Luz Palliative Care
Practice address
1840 S Stapley Dr Ste 225B
Mesa, AZ 85204-6685
Phone
(480) 801-2416
Fax
(480) 801-2417
NPI assigned
Nov 13, 2020
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Joshua L Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X Primary
Family Medicine Physician 207Q00000X

Addresses

Primary practice location

1840 S Stapley Dr Ste 225B
Mesa, AZ 85204-6685

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other practice location 1

2152 S Vineyard Ste 118
Mesa, AZ 85210-6881
Phone (480) 895-5434

Other practice location 2

1910 S Stapley Dr Ste 202B
Mesa, AZ 85204-6679
Phone (480) 801-2416

Other names 1

  • Casa de la Luz Palliative Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210410000008 AZ Part B Supplier - Clinic/Group Practice 7416365580 Receives reassigned benefits from 4 practitioners
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Locations

1840 S Stapley Dr
Ste 225B
Mesa, AZ 85204
Phone (480) 801-2416

1840 S Stapley Dr
Ste 255B
Mesa, AZ 85204

1910 S Stapley Dr
Ste 202B
Mesa, AZ 85204
Phone (480) 801-2416

2152 S Vineyard
Ste 118
Mesa, AZ 85210
Phone (480) 801-2416

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1407458532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-443-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 S STAPLEY DR STE 225B",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046685",
            "telephone_number": "480-801-2416",
            "fax_number": "480-801-2417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2152 S Vineyard Ste 118",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852106881",
            "country_code": "US",
            "telephone_number": "480-895-5434",
            "fax_number": "480-305-5782",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1910 S Stapley Dr Ste 202B",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852046679",
            "country_code": "US",
            "telephone_number": "480-801-2416",
            "fax_number": "480-801-2417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LHCG CLXXII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-13",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Casa de la Luz Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.