Organization Active NPI

Prestige Companion Care, LLC

  • Home Health Agency
  • Phoenix, AZ
National Provider Identifier
1427925122
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Oct 20, 2025

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)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.