Prevencare Health Services, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PREVENCARE HEALTH SERVICES, LLC

Practice address

750 Bartow Dr Ste 16
Sierra Vista, AZ 85635-1833

Phone

(858) 449-3798

NPI assigned

Sep 2, 2020

Organization subpart

No

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

Authorized official

Name

Erick Lee, ERICK LEE

Title

Owner

Phone

(858) 449-3798

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PrevenCare Health Services, LLC Former legal business name

Electronic endpoints 1

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1447864830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 S APACHE DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852866300",
            "telephone_number": "858-449-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BARTOW DR STE 16",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856351833",
            "telephone_number": "858-449-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENCARE HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ERICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-449-3798",
        "authorized_official_credential": "ERICK LEE"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "441076",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Office",
            "affiliation": "N",
            "endpointDescription": "main location",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Direct",
            "address_1": "750 Bartow Dr Ste 16",
            "city": "Sierra Vista",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "856351833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PrevenCare Health Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PrevenCare Health Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Tracy Post, PHARM.D.
• Maureen Kathryn Potucek
• April Michelle Power, DNP
• Frederick Eugene Powers Jr., FNP-BC
• Corey Poynor-Dunning
• Angela E Price, PHARMD
• Marsha A Prince, WHCNP
• Nathaniel A Ptak
• Pueblo del Sol Dental Care LLC
• Raul E Quilihua Jr.

• Family Medicine Physician in Sierra Vista, AZ
• Providers in Sierra Vista, 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 2, 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.