Virginia Prendergast, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP6877 Issued in AZ

Practice address

1424 E Marshall Ave
Phoenix, AZ 85014-2358

Phone

(480) 220-4688

Fax

(602) 406-4969

NPI assigned

Nov 8, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1578633657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 E MARSHALL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142358",
            "telephone_number": "480-220-4688",
            "fax_number": "602-406-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 E MARSHALL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142358",
            "telephone_number": "480-220-4688",
            "fax_number": "602-406-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENDERGAST",
        "first_name": "VIRGINIA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN039088",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "AP6877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brandon Prendiville, MC, LAC
• Stacy Brooke Prendiville, PT, DPT
• Leanne Sue Prenovost, RN, MBA
• Maxim Rennie Prentice
• Lawrence Presant, D.O.

• Adult Health Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2015; 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.