BLUE RIVER HEALTH & WELLNESS, PLLC
NPI 1356073852
Nurse Practitioner - Family in Fort Mohave, AZ
About Blue River Health & Wellness, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLUE RIVER HEALTH & WELLNESS, PLLC (NPI 1356073852) is a healthcare organization registered as a family in Fort Mohave, Arizona and active in the NPI registry since June 2022. The organization lists Nicole Ann Roberts, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Blue River Health & Wellness, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Blue River Health & Wellness, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Blue River Health & Wellness, PLLC's NPI number?
The NPI number for Blue River Health & Wellness, PLLC is 1356073852. It was assigned to this organization in the NPPES registry on June 24, 2022.
Where is Blue River Health & Wellness, PLLC located?
Blue River Health & Wellness, PLLC is located at 1520 E Hammer Ln Ste 104, Fort Mohave, AZ 86426. The listed phone number is (602) 315-0211.
What is Blue River Health & Wellness, PLLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Blue River Health & Wellness, PLLC enrolled in Medicare?
Yes. Blue River Health & Wellness, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Blue River Health & Wellness, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Blue River Health & Wellness, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Blue River Health & Wellness, PLLC was last updated on June 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Blue River Health & Wellness, Pllc · NPI 1356073852
Family organization in Fort Mohave, Arizona. Organization record, active in the CMS NPPES registry since June 24, 2022.
## Identity
- **NPI:** 1356073852 (Entity type: Organization)
- **Enumerated:** June 24, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Nicole Roberts, OWNER
## Practice location
- **Address:** 1520 E HAMMER LN STE 104, Fort Mohave, AZ 86426-6665
- **Phone:** (602) 315-0211
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 24, 2022
- **Other identifiers:** Other 23375081 (AZ)
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Source: [NPI Profile](https://npiprofile.com/npi/1356073852) · Data from the CMS NPPES public registry.