Agape Primary Care, PLLC

Key facts

NPI

1992236848

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

Legal business name

AGAPE PRIMARY CARE, PLLC

Practice address

8380 W Emile Zola Ave # 5178
Peoria, AZ 85381-4811

Phone

(623) 219-7768

Fax

(480) 436-6926

NPI assigned

Mar 22, 2017

Organization subpart

No

Authorized official

Name

Paulina Simon NPI 1962959346

Title

Owner

Phone

(623) 219-7768

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paulina Simon, AGPCNP Primary Care Nurse Practitioner · Peoria, AZ · NPI 1962959346
  Medicare reassignment NPD Authorized official AZ
• Valarie C. Grogan, DO Internal Medicine Physician · Phoenix, AZ · NPI 1912085655
  Medicare reassignment NPD AZ
• Jane Kinstler, FNP-C Family Nurse Practitioner · Glendale, AZ · NPI 1235521147
  Medicare reassignment NPD AZ
• Sorana Liana Pop, FNP Family Nurse Practitioner · Phoenix, AZ · NPI 1164802690
  Medicare reassignment NPD AZ

Medicare participation

Medicare fee-for-service enrollment

Enrolled in AZ

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 22, 2017.

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490140800000",
    "number": "1992236848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8380 W EMILE ZOLA AVE # 5178",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814811",
            "telephone_number": "623-219-7768",
            "fax_number": "480-436-6926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8380 W EMILE ZOLA AVE # 5178",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814811",
            "telephone_number": "623-219-7768",
            "fax_number": "480-436-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-22",
        "last_updated": "2017-03-22",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "PAULINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-219-7768"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Peoria, AZ · Family Medicine Physician in Arizona