PRESTIGE INTERVENTIONAL GROUP, LLC (NPI# 1891236998) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891236998 |
| Entity Type | Organization |
| Organization Name | PRESTIGE INTERVENTIONAL GROUP, LLC |
| Practice Address |
3724 N 3rd St Suite 302 Phoenix AZ 85012-2034 |
| Mailing Address |
3724 N 3rd St Suite 301 Phoenix AZ 85012-2034 |
| Practice Telephone | 6026748185 |
| Practice Fax Number | 6026748117 |
| Mailing Telephone | 7604869634 |
| Mailing Fax Number | 4804716315 |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2017-03-09 |
| Authorized Official Name | MR. CHALLEN WAYCHOFF III (COO/MANAGER) |
| Authorized Official Telephone | 7604869634 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
3724 N 3RD ST SUITE 302 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-2034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437525797 | Addiction Recovery Centers, LLC | Counselor | 3724 N 3rd St, Ste 201, Phoenix, AZ 85012-2034 | 2015-08-20 |
| 1962041988 | Scoliosis Az Centers LLC | Physical Medicine & Rehabilitation | 3724 N 3rd St, Phoenix, AZ 85012-2034 | 2019-12-23 |
| 1679014765 | Uptown Facility, LLC | Clinic/Center | 3724 N 3rd St, Suite 302, Phoenix, AZ 85012-2034 | 2017-03-09 |
| 1609319813 | Colt Anesthesia, LLC | Anesthesiology | 3724 N 3rd St, Suite 301, Phoenix, AZ 85012-2034 | 2016-11-21 |
| 1114477791 | Uptown Painstop, LLC | Case Manager/Care Coordinator | 3724 N 3rd St, Suite 300, Phoenix, AZ 85012-2034 | 2016-10-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
| Find all providers in zip 85012 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
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| 1093339202 | Right Path Treatment Center LLC | Clinic/Center | 8222 S 48th St Unit 180, Phoenix, AZ 85044-5364 | 2020-06-03 |
| 1871148254 | Bescare Home LLC | Clinic/Center | 5320 S 34th Dr, Phoenix, AZ 85041-7415 | 2019-08-02 |
| 1508325929 | Ican America | Clinic/Center | Cityscape Tower 1 E Washington St., Suite 440, Phoenix, AZ 85004 | 2019-03-15 |
| 1043790801 | United Rcm LLC | Clinic/Center | 1202 E Alta Vista Rd, Phoenix, AZ 85042-4432 | 2018-08-20 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.