Prism Wellness Center PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRISM WELLNESS CENTER PLLC

Practice address

9299 W Olive Ave Ste 604
Peoria, AZ 85345-8386

Phone

(610) 772-3325

Fax

(866) 398-8310

NPI assigned

Mar 28, 2024

Organization subpart

No

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

Authorized official

Name

Carolyn Collier, NP

Title

NP

Phone

(610) 772-3325

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1407607336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14175 W INDIAN SCHOOL RD # SETB4195",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958407",
            "telephone_number": "610-772-3325",
            "fax_number": "866-398-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9299 W OLIVE AVE STE 604",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458386",
            "telephone_number": "610-772-3325",
            "fax_number": "866-398-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "610-772-3325",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.