Active NPI
Prestige Companion Care, LLC
- Home Health Agency
- Phoenix, AZ
National Provider Identifier
1427925122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- PRESTIGE COMPANION CARE, LLC
- Practice address
- 522 N Central Ave
Phoenix, AZ 85004-2185 - Phone
- (480) 331-3815
- NPI assigned
- Oct 20, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gary Randall Moore
- Title
- Ceo
- Phone
- (602) 456-9358
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | |||
| Health & Wellness Coach | 171400000X | |||
| Home Health Agency | 251E00000X | Primary | ||
| Home Delivered Meals | 332U00000X |
Addresses
Primary practice location
522 N Central Ave
Phoenix, AZ 85004-2185
Mailing address
522 N Central Ave
Phoenix, AZ 85004-2185
Phone (480) 331-3815
National Provider Directory
National Provider DirectoryLocations
522 N Central Ave
Phoenix, AZ 85004
Phone (480) 331-3815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760918400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1760918400000",
"number": "1427925122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "522 N CENTRAL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850042185",
"telephone_number": "480-331-3815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "522 N CENTRAL AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850042185",
"telephone_number": "480-331-3815"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRESTIGE COMPANION CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-20",
"last_updated": "2025-10-20",
"certification_date": "2025-10-19",
"status": "A",
"authorized_official_last_name": "MOORE",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "RANDALL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "602-456-9358",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "332U00000X",
"taxonomy_group": "",
"desc": "Home Delivered Meals",
"state": null,
"license": null,
"primary": false
}
],
"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 Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.