NPIMap

Organization Active NPI

Your Health and Wellness PLLC

  • Primary Care Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1992476543
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
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
Last updated
Dec 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Mark Knoblauch, FNP-BCNPI 1356072953
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)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@yourhealthaz.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2239003Your Health and Wellness3326 N 3Rd Ave Ste 201, Phoenix, AZ 85013Certificate of waiverOct 6, 2027

National Provider Directory

National Provider Directory

Locations

3326 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 274-2351

3326 N 3rd Ave
Ste 201
Phoenix, AZ 85013
Phone (602) 625-7944

625 W Glenrosa Ave Ste 104
Phoenix, AZ 85013

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27169/brand/1/csg/1/fhir/r4
  • Direct secure messaging: info@yourhealthaz.com

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

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": [],
    "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.

Verify at the official NPI Registry.