Organization Active NPI

Blue Hills Medical LLC

  • Family Nurse Practitioner
  • Prescott Valley, AZ
National Provider Identifier
1821847989
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
BLUE HILLS MEDICAL LLC
Practice address
8363 E Florentine Rd Ste B
Prescott Valley, AZ 86314-4972
Phone
(928) 800-1228
Fax
(928) 268-0143
NPI assigned
May 13, 2024
Last updated
Mar 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Holly Engelman, PMHNP, FNPNPI 1346790748
Title
Nurse Practitioner
Phone
(928) 800-1228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

8363 E Florentine Rd Ste B
Prescott Valley, AZ 86314-4972

Mailing address

8363 E Florentine Rd Ste B
Prescott Valley, AZ 86314-4972
Phone (928) 800-1228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250423001696 AZ Part B Supplier - Clinic/Group Practice 0345765293 Receives reassigned benefits from 1 practitioner
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

8363 E Florentine Rd
Ste B
Prescott Valley, AZ 86314
Phone (928) 800-1228

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1821847989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8363 E FLORENTINE RD STE B",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863144972",
            "telephone_number": "928-800-1228",
            "fax_number": "928-268-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8363 E FLORENTINE RD STE B",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863144972",
            "telephone_number": "928-800-1228",
            "fax_number": "928-268-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HILLS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "ENGELMAN",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "928-800-1228",
        "authorized_official_credential": "PMHNP, FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.