Active NPI
Your Health and Wellness PLLC
- Primary Care Clinic/Center
- Phoenix, AZ
National Provider Identifier
1992476543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- YOUR HEALTH AND WELLNESS PLLC
- Practice address
- 3326 N 3Rd Ave Ste 201
Phoenix, AZ 85013-4336 - Phone
- (602) 625-7944
- NPI assigned
- Sep 23, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mark Knoblauch, FNP-BC
- Title
- Owner
- Phone
- (602) 625-7944
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary | ||
| Adult Health Nurse Practitioner | 363LA2200X |
Addresses
Primary practice location
3326 N 3Rd Ave Ste 201
Phoenix, AZ 85013-4336
Mailing address
3326 N 3Rd Ave Ste 201
Phoenix, AZ 85013-4336
Phone (602) 625-7944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103753 | Medicaid | AZ |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@yourhealthaz.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220929003372 | AZ | Part B Supplier - Clinic/Group Practice | 8426434333 |
Receives reassigned benefits from 6 practitioners Practice locations: Phoenix, AZ |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2239003 | Your Health and Wellness | Certificate of waiver | Oct 6, 2027 |
National Provider Directory
National Provider DirectoryLocations
625 W Glenrosa Ave Ste 104
Phoenix, AZ 85013
3326 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 274-2351
635 W Glenrosa Ave
Ste 104
Phoenix, AZ 85013
Phone (602) 625-7944
Interoperability endpoints
- https://api.platform.athenahealth.com/27169/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 23
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Phoenix, AZ
- NPI 1316516065
AZ
-
- Medical Physician Assistant
- Phoenix, AZ
- NPI 1386201440
-
- Nurse Practitioner
- Phoenix, AZ
- NPI 1396368924
-
- Pulmonary Disease Physician
- Phoenix, AZ
- NPI 1841523545
-
- Pulmonary Disease Physician
- Phoenix, AZ
- NPI 1649434887
-
- Pulmonary Disease Physician
- Phoenix, AZ
- NPI 1417059742
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632355200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1703030400000",
"number": "1992476543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3326 N 3RD AVE STE 201",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134336",
"telephone_number": "602-625-7944",
"fax_number": "602-865-7576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3326 N 3RD AVE STE 201",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850134336",
"telephone_number": "602-625-7944"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YOUR HEALTH AND WELLNESS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-23",
"last_updated": "2023-12-20",
"certification_date": "2023-12-20",
"status": "A",
"authorized_official_last_name": "KNOBLAUCH",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "602-625-7944",
"authorized_official_credential": "FNP-BC"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103753",
"state": "AZ"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@yourhealthaz.com",
"affiliation": "N",
"endpointDescription": "secure email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3326 N 3rd Ave Ste 201",
"city": "Phoenix",
"state": "AZ",
"country_code": "US",
"postal_code": "850134336",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.