Priola Primary Palliative and Hospice Care, PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP3629 Issued in AZ

Legal business name

PRIOLA PRIMARY PALLIATIVE AND HOSPICE CARE, PLLC

Practice address

3105 Clearwater Dr Ste B
Prescott, AZ 86305-7166

Phone

(928) 778-0626

Fax

(888) 289-2598

NPI assigned

Jun 21, 2016

Organization subpart

No

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

Authorized official

Name

Mark Priola, FNP-C

Title

Owner

Phone

(928) 778-0626

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Reneallia Bennett, NP

  • Primary Care Nurse Practitioner
  • Prescott Valley, AZ
  • NPI 1023362886
  NPD (past)

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1710337621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 CLEARWATER DR STE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057166",
            "telephone_number": "928-778-0626",
            "fax_number": "888-289-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 CLEARWATER DR STE B",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057166",
            "telephone_number": "928-778-0626",
            "fax_number": "888-289-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIOLA PRIMARY PALLIATIVE AND HOSPICE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PRIOLA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-778-0626",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "575416",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407161235",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.