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PRIVIA MEDICAL GROUP ARIZONA, LLC
NPI 1245876705
Psychiatry & Neurology - Neurology in Phoenix, AZ

Active since November 20, 2019CLIA Certified · 7 labs
14001 N 7TH ST STE F111, PHOENIX, AZ 85022(602) 633-3780(602) 633-3782 Get Directions Write a Review

NPPES record last updated: May 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Privia Medical Group Arizona, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIVIA MEDICAL GROUP ARIZONA, LLC (NPI 1245876705) is a healthcare organization registered as a neurology in Phoenix, Arizona and active in the NPI registry since November 2019. The organization holds 7 active CLIA laboratory certificates and lists Mindy Smith, Ceo, as its authorized official.

NPPES Registry Identity

NPI1245876705
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NamePRIVIA MEDICAL GROUP ARIZONA, LLC
Location Address14001 N 7TH ST STE F111Phoenix, AZ 85022-4382
Mailing Address3815 E Bell Rd Ste 2200Phoenix, AZ 85032-2139 · (602) 633-3848 · Fax (602) 633-3841
Phone(602) 633-3780
Fax(602) 633-3782
Organization SubpartNo
Authorized OfficialMindy SmithCeo · (602) 633-3811
Enumeration DateNovember 20, 2019
Last NPPES UpdateMay 2, 2025
NPPES CertifiedMay 2, 2025
✔ NPI 1245876705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
14001 N 7TH ST STE F111, Phoenix, AZ 85022
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 7

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2147449

Privia Medical Group Arizona, LLC · Phoenix, AZ
Active · expires Apr 18, 2028
CLIA Number03D2147449
Laboratory TypePhysician Office
Certificate Effective DateApril 19, 2026
Certificate Expiration DateApril 18, 2028
Laboratory DirectorIslam Abujubara
Laboratory Phone(602) 633-3848
Laboratory LocationPrivia Medical Group Arizona, LLC14001 N 7th St Ste F111, Phoenix, AZ 85022
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 03D2084233

Privia Medical Group Arizona, LLC Dba Ims Care Center LLC · Avondale, AZ
Active · expires Nov 8, 2027
CLIA Number03D2084233
Laboratory TypePhysician Office
Certificate Effective DateNovember 9, 2025
Certificate Expiration DateNovember 8, 2027
Laboratory DirectorRiyaz Sumar
Laboratory Phone(602) 633-3848
Laboratory LocationPrivia Medical Group Arizona, LLC Dba Ims Care Center LLC10815 W Mcdowell Rd, Ste 203, Avondale, AZ 85392
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 03D2065272

Privia Medical Group Arizona, LLC · Phoenix, AZ
Active · expires Sep 5, 2027
CLIA Number03D2065272
Laboratory TypePhysician Office
Certificate Effective DateSeptember 6, 2025
Certificate Expiration DateSeptember 5, 2027
Laboratory DirectorRiyaz Sumar
Laboratory Phone(602) 633-3848
Laboratory LocationPrivia Medical Group Arizona, LLC3815 East Bell Rd, Ste 3300, Phoenix, AZ 85032
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D2099043

Privia Medical Group Arizona, LLC · Payson, AZ
Active · expires Jul 19, 2027
CLIA Number03D2099043
Laboratory TypePhysician Office
Certificate Effective DateJuly 20, 2025
Certificate Expiration DateJuly 19, 2027
Laboratory DirectorJohn E. Vandruff
Laboratory Phone(602) 633-3848
Laboratory LocationPrivia Medical Group Arizona, LLC111 W Cedar Lane, Ste A, Payson, AZ 85541
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D1101834

Privia Medical Group Arizona, LLC · Goodyear, AZ
Active · expires Jul 6, 2027
CLIA Number03D1101834
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2025
Certificate Expiration DateJuly 6, 2027
Laboratory DirectorNavtej S. Tung
Laboratory Phone(602) 633-3848
Laboratory LocationPrivia Medical Group Arizona, LLC14415 W Mcdowell #d102, Goodyear, AZ 85395
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 03D0984373

Privia Medical Group Arizona, LLC · Phoenix, AZ
Active · expires Jun 23, 2027
CLIA Number03D0984373
Laboratory TypePhysician Office
Certificate Effective DateJune 24, 2025
Certificate Expiration DateJune 23, 2027
Laboratory DirectorMichael Drury MD
Laboratory Phone(602) 633-3848
Laboratory LocationPrivia Medical Group Arizona, LLC3815 E Bell Rd, Ste 4100, Phoenix, AZ 85032
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. RACHAEL BENNETT FNP-C
Nurse Practitioner
14001 N 7TH ST STE F111
PHOENIX, AZ 85022
Maricopa County (602) 633-3780
TRACEY LYNN REDISH
Nurse Practitioner (Family)
14001 N 7TH ST STE F111
PHOENIX, AZ 85022
Maricopa County (602) 633-3780

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Privia Medical Group Arizona, LLC's NPI number?

The NPI number for Privia Medical Group Arizona, LLC is 1245876705. It was assigned to this organization in the NPPES registry on November 20, 2019.

Where is Privia Medical Group Arizona, LLC located?

Privia Medical Group Arizona, LLC is located at 14001 N 7th St Ste F111, Phoenix, AZ 85022. The listed phone number is (602) 633-3780.

What is Privia Medical Group Arizona, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Does Privia Medical Group Arizona, LLC hold CLIA laboratory certificates?

Yes. 7 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Privia Medical Group Arizona, LLC was last updated on May 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.