Peaks Primary Care, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

PEAKS PRIMARY CARE, LLC

Practice address

919 12TH PL Ste 5
Prescott, AZ 86305-1433

Phone

(928) 582-6055

Fax

(928) 445-0166

NPI assigned

Feb 9, 2023

Last updated

Oct 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teri Ellerbe

Title

Administrator

Phone

(602) 851-3030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Kirkham, FNP/PMHNP

  • Family Nurse Practitioner
  • Mesa, AZ
  • NPI 1669010757
  Medicare reassignment NPD
• Marcia S Mulcahey, NP

  • Adult Health Nurse Practitioner
  • Prescott, AZ
  • NPI 1386670024
  Medicare reassignment NPD
• Cynthia Tortorella, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
  • NPI 1023589512
  Medicare reassignment NPD

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1700583879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 12TH PL STE 5",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "928-582-6055",
            "fax_number": "928-445-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 12TH PL STE 5",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "928-582-6055",
            "fax_number": "928-445-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAKS PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "ELLERBE",
        "authorized_official_first_name": "TERI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-851-3030"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Patterson, LMT
• Brenda C Patton, MD
• Matthew Pavelka, M.D.
• Ben Eugene Paxton, M.D.
• PC Pain Doctors II, PLLC
• Peaks Youth Behavioral Health Center, LLC
• Peaks Youth Behavioral Health Center, LLC
• Peaks Youth Behavoral Center LLC
• Michele H Pearson, RN
• Pediatrics in the Pines (Occupational Therapsit)

• Primary Care Nurse Practitioner in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Primary Care Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.